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Cited by 277Ophthalmology and Visual Impairment StudiesGlaucoma and retinal disordersHealth disparities and outcomes

Vision Health Disparities in the United States by Race/Ethnicity, Education, and Economic Status: Findings From Two Nationally Representative Surveys

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Zhang, Xinzhi, Cotch, Mary Frances, Ryskulova, Asel, Primo, Susan A., Nair, Parvathy, Chou, Chiu-Fang, Geiss, Linda S., Barker, Lawrence E. +3 more·2012·American Journal of Ophthalmology
DOI 10.1016/j.ajo.2011.08.045PMC PMC4169111
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Abstract

Purpose To assess vision health disparities in the United States by race/ethnicity, education, and economic status. Design Cross-sectional, nationally representative samples. Methods We used national survey data from the National Health and Nutrition Examination Survey (NHANES) and the National Health Interview Survey (NHIS). Main outcome measures included, from NHANES, age-related eye diseases (ie, age-related macular degeneration [AMD], cataract, diabetic retinopathy [DR], glaucoma) and from NHIS, eye care use (ie, eye doctor visits and cannot afford eyeglasses when needed) among those with self-reported visual impairment. The estimates were age- and sex-standardized to the 2000 US Census population. Linear trends in the estimates were assessed by weighted least squares regression. Results Non-Hispanic whites had a higher prevalence of AMD and cataract surgery than non-Hispanic blacks, but a lower prevalence of DR and glaucoma (all P < .001 in NHANES 2005-2008). From 1999 to 2008, individuals with less education (ie, <high school vs >high school) and lower income (poverty income ratio [PIR] <1.00 vs ≥ 4.00) were consistently less likely to have had an eye care visit in the past 12 months compared with their counterparts (all P < .05). During this period, inability to afford needed eyeglasses increased among non-Hispanic whites and Hispanics (trend P = .004 and P = .007; respectively), those with high school education (trend P = .036), and those with PIR 1.00-1.99 (trend P < .001). Conclusions Observed vision health disparities suggest a need for educational and innovative interventions among socioeconomically disadvantaged groups.

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  • The majority of the 34 million people with diabetes in the US have a DED screening care gap, due to a lack of access, and education around the need for a diabetic eye exam.

    “the majority of the 34 million people with diabetes in the US have a DED screening care gap, due to a lack of access, and education around the need for a diabetic eye exam3,4.”

    From Autonomous artificial intelligence increases screening and follow-up for diabetic retinopathy in youth: the ACCESS randomized control trial (2024) · cites this paper as [3]

    The Discussion (Vision Health Disparities and Public Health Implications; page not provided) identifies access and awareness barriers to eye care and says challenges remain in getting people at risk screened for diabetic retinopathy. It does not establish that a majority of the 34 million US residents with diabetes have a diabetic-eye-exam screening gap, or that lack of access and education explain such a gap in that population. (LLM, conf=0.86)

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Authors
Zhang, X., Cotch, M. F., Ryskulova, A., Primo, S. A., Nair, P., Chou, C.-F., Geiss, L. S., Barker, L. E., Elliott, A. F., Crews, J. E., & Saaddine, J. B.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • National Institutes of Health (US)
  • Emory University (US)
Corresponding author
Zhang, Xinzhi
ORCID
Venue
American Journal of Ophthalmology
Publisher
Elsevier BV
Published
2012-12
Volume
154
Issue
6
Pages
S53-S62.e1
ISSN
0002-9394 (ISSN-L)
DOI
10.1016/j.ajo.2011.08.045
PMC
PMC4169111
OpenAlex
W2078224874
Cited by
277
References
1
Citations by year
2026: 15 · 2025: 33 · 2024: 33 · 2023: 39 · 2022: 28 · 2021: 35 · 2020: 20 · 2019: 11 · 2018: 16 · 2017: 11 · 2016: 11 · 2015: 13 · 2014: 7 · 2013: 5
FWCI
5.99
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (Z99 EY999999)
  • U.S. Public Health Service (ZIAEY000402)
  • National Eye Institute (ZIAEY000402, Z01EY000402)
Topics
  • Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
  • Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
  • Social Sciences › Health › Health disparities and outcomes
Keywords
racial and ethnic disparities, socioeconomic status, educational attainment, income, age-related macular degeneration, cataract surgery, diabetic retinopathy, glaucoma, eye care utilization, visual impairment, poverty income ratio, NHANES, NHIS
MeSH terms
Adult, Cataract, Cross-Sectional Studies, Diabetic Retinopathy, Educational Status, Ethnicity, Eye Diseases, Glaucoma, Health Services, Health Services Accessibility, Humans, Macular Degeneration, Nutrition Surveys, Socioeconomic Factors, United States, Databases, Factual, Racial Groups, Healthcare Disparities

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