TY - JOUR
T1 - The Impact of Social Determinants of Health on Vision Loss From Cataracts and Cataract Surgery Utilization in the United States—A National Health Interview Survey Analysis
AU - Awidi, Abdelhalim A.
AU - Wang, Jiangxia
AU - Varadaraj, Varshini
AU - Ali, Muhammad
AU - Cai, Cindy X.
AU - Sommer, Alfred
AU - Ramulu, Pradeep Y.
AU - Woreta, Fasika A.
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/10
Y1 - 2023/10
N2 - Purpose: To investigate the association of social determinants of health (SDOH) factors and cataract-related outcomes disparities. Design: Cross-sectional, with a nationally representative sample. Methods: We used publicly available data from the 2008, 2016, and 2017 National Health Interview Survey data sets. Outcome measures included self-reported prevalence for ever been diagnosed with cataract, vision loss secondary to cataracts, and the likelihood of undergoing cataract surgery. Survey-weighted, multivariable logistic regression models, adjusted for age, race and ethnicity, and other relevant covariates, were used to examine the association between SDOH factors and cataract-related outcomes. Results: A total of 81,551 participants were included, who were predominantly between 18 and 44 years of age (49.6%), female (51.7%), and White (74.8%). Multivariable regression models with age as a covariate showed that individuals who were not working were more likely to report having cataracts than those who were working (P <.001). Those who needed but could not afford medical care in the past year were more likely to report vision loss secondary to cataracts than their counterparts (P <.001). Uninsured participants were less likely to report undergoing cataract surgery than those with private insurance (P =.03). Individuals with higher income (poverty-income ratio: 1.00-2.99 vs <1.00) were more likely to report undergoing cataract surgery (P =.04). Conclusions: Several SDOH factors were associated with disparities in rates of cataract-related outcomes. These findings highlight the importance of ophthalmologists screening for social risks in patients with cataract, as these social factors are important barriers for access to care.
AB - Purpose: To investigate the association of social determinants of health (SDOH) factors and cataract-related outcomes disparities. Design: Cross-sectional, with a nationally representative sample. Methods: We used publicly available data from the 2008, 2016, and 2017 National Health Interview Survey data sets. Outcome measures included self-reported prevalence for ever been diagnosed with cataract, vision loss secondary to cataracts, and the likelihood of undergoing cataract surgery. Survey-weighted, multivariable logistic regression models, adjusted for age, race and ethnicity, and other relevant covariates, were used to examine the association between SDOH factors and cataract-related outcomes. Results: A total of 81,551 participants were included, who were predominantly between 18 and 44 years of age (49.6%), female (51.7%), and White (74.8%). Multivariable regression models with age as a covariate showed that individuals who were not working were more likely to report having cataracts than those who were working (P <.001). Those who needed but could not afford medical care in the past year were more likely to report vision loss secondary to cataracts than their counterparts (P <.001). Uninsured participants were less likely to report undergoing cataract surgery than those with private insurance (P =.03). Individuals with higher income (poverty-income ratio: 1.00-2.99 vs <1.00) were more likely to report undergoing cataract surgery (P =.04). Conclusions: Several SDOH factors were associated with disparities in rates of cataract-related outcomes. These findings highlight the importance of ophthalmologists screening for social risks in patients with cataract, as these social factors are important barriers for access to care.
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U2 - 10.1016/j.ajo.2023.03.017
DO - 10.1016/j.ajo.2023.03.017
M3 - Article
C2 - 36963606
AN - SCOPUS:85166616561
SN - 0002-9394
VL - 254
SP - 44
EP - 53
JO - American journal of ophthalmology
JF - American journal of ophthalmology
ER -