Department of Optometry, UNESCO Chair of Visual Health, Universitat Politècnica de Catalunya, Barcelona, Spain.
Indian J Ophthalmol. 2012 Sep-Oct;60(5):368-75. doi: 10.4103/0301-4738.100529.
Health inequities are related to social determinants based on gender, socioeconomic status, ethnicity, race, living in a specific geographic region, or having a specific health condition. Such inequities were reviewed for blindness and visual impairment by searching for studies on the subject in PubMed from 2000 to 2011 in the English and Spanish languages. The goal of this article is to provide a current review in understanding how inequities based specifically on the aforementioned social determinants on health influence the prevalence of visual impairment and blindness. With regards to gender inequality, women have a higher prevalence of visual impairment and blindness, which cannot be only reasoned based on age or access to service. Socioeconomic status measured as higher income, higher educational status, or non-manual occupational social class was inversely associated with prevalence of blindness or visual impairment. Ethnicity and race were associated with visual impairment and blindness, although there is general confusion over this socioeconomic position determinant. Geographic inequalities and visual impairment were related to income (of the region, nation or continent), living in a rural area, and an association with socioeconomic and political context was suggested. While inequalities related to blindness and visual impairment have rarely been specifically addressed in research, there is still evidence of the association of social determinants and prevalence of blindness and visual impairment. Additional research should be done on the associations with intermediary determinants and socioeconomic and political context.
健康不平等与社会决定因素有关，这些因素基于性别、社会经济地位、族裔、种族、居住在特定地理区域或特定健康状况。通过在 PubMed 中以英文和西班牙文搜索 2000 年至 2011 年的相关研究，对失明和视力障碍进行了此类不平等的审查。本文的目的是提供一个关于如何理解上述社会决定因素对健康的影响如何影响视力障碍和失明的流行率的最新综述。关于性别不平等，女性的视力障碍和失明患病率较高，这不能仅仅归因于年龄或获得服务的机会。以高收入、高教育程度或非体力劳动职业社会阶层衡量的社会经济地位与失明或视力障碍的患病率呈反比。族裔和种族与视力障碍和失明有关，但对于这一社会经济地位决定因素，存在普遍的混淆。地理不平等与视力障碍与收入（地区、国家或大陆）有关，与农村地区的生活有关，并且表明与社会经济和政治背景有关。虽然与失明和视力障碍相关的不平等在研究中很少得到专门解决，但仍有证据表明社会决定因素与失明和视力障碍的流行率之间存在关联。应进一步研究与中介决定因素和社会经济及政治背景的关联。
