Neighborhood Measures of Inequity and Visual Impairment and Blindness

Abstract

Purpose : Social risk factors (SRFs) impacting poor health include segregation, income inequality, and persistent poverty. This study aimed to investigate the association between these SRFs and visual impairment and blindness (VIB) in neighborhoods.

Methods : Nationwide census-tract (CTs) estimates for VIB, SRFs, and demographic characteristics were obtained from PolicyMap and 2012-2016 American Community Survey data. The Theil’s H Index is a measure of neighborhood racial segregation with higher values representing more segregation (range 0-1). The Gini Index is an estimate of inequality of household income with higher values representing more inequality (range 0-1). Persistent poverty is defined as a CT with 20% or more of the population living in poverty for over the past 30 years. VIB was defined as “is this person blind or do they have difficulty seeing even when wearing glasses.” CT measures of SRFs, demographics, and VIB were summarized with descriptive statistics. Logistic regression models were used to assess the effect of CT SRF measures on the probability of VIB, adjusting for CT demographic characteristics.

Results : In total, 73,198 CTs were analyzed. CTs had an average of 2.5% of residents with VIB (standard deviation, SD=1.9), an average Theil’s H Index of 0.22 (SD=0.13), Gini index of 0.42 (SD=0.06), and 8.4% of CTs had persistent poverty. CTs had an average median age of 39.2 years old (SD=7.7), population size of 4,332 people (SD=2,124), average percentage of people of color of 38.2% (SD=30.7), and average percentage of female residents of 50.8 (SD=4.3). Logistic regression found that for every 0.1-unit increase in Theil’s H Index and Gini Index, there was a 14.4% and 15.0% increase in odds of having VIB after controlling for CT-level demographics (odds ratio, OR: 1.14 and 1.15; 95% confidence interval, CI: 1.14-1.15 and 1.15-1.15; both p<0.001, respectively). Persistent poverty was associated with a 35.6% increase in odds of having VIB after controlling for CT-level demographics compared to non-persistent poverty CTs (OR: 1.36; 95% CI: 1.35- 1.36; p<0.001).

Conclusions : Residential measures of inequity were found to be associated with a greater number of residents living with VIB. It is essential to understand and address how poverty and segregation impact VIB.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.