Lin Po-Jen, Abraham Alison G, Ramulu Pradeep, Mihailovic Aleks, Kucharska-Newton Anna, Guo Xinxing
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Department of Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA.
Transl Vis Sci Technol. 2025 Jan 2;14(1):8. doi: 10.1167/tvst.14.1.8.
Uncorrected visual impairment (VI) significantly impacts life quality and exacerbates age-related health issues. Social determinants of health (SDOH) are associated with uncorrected VI, but quantitative evidence is limited. This study investigated the link between SDOH and uncorrected VI among aging adults to identify disparities and improve vision care.
We used data from the Atherosclerosis Risk in Communities (ARIC) study visits 4 and 6 and the ancillary Eye Determinants of Cognition (EyeDOC) study. We included subjects who were >70 years old and extracted their sex, race, residence, household income, education level, having an eye doctor, health insurance status, and Area Deprivation Index (ADI) and vision outcomes. Uncorrected VI was categorized into uncorrected distance (UDVI) or near visual impairment (UNVI). Associations between SDOH indicators and VI were evaluated using logistic regressions.
Among 967 adults (mean ± SD age, 78.6 ± 4.35 years; 37.9% male), UDVI was found in 293 and UNVI in 186. Living in Jackson, MS, was associated with lower odds for UNVI (adjusted odds ratio [aOR] = 0.36; 95% CI, 0.20-0.65). Higher odds for UNVI were associated with male sex (aOR = 2.01; 95% CI, 1.41-2.87), low educational attainment (aOR for not completing high school = 2.32; 95% CI, 1.37-3.92; aOR for high school only = 1.92; 95% CI, 1.26-2.92), no eye doctor (aOR = 1.58; 95% CI, 1.05-2.39), and having government health insurance only (aOR = 1.48; 95% CI, 1.00-2.17). Associations between SDOH factors and UDVI were weaker or non-existent.
This study links SDOH factors to uncorrected VI among older adults.
SDOH should be considered when designing interventions to reduce VI in vulnerable communities.
未矫正的视力损害（VI）会显著影响生活质量，并加剧与年龄相关的健康问题。健康的社会决定因素（SDOH）与未矫正的VI有关，但定量证据有限。本研究调查了老年人中SDOH与未矫正的VI之间的联系，以识别差异并改善视力保健。
我们使用了社区动脉粥样硬化风险（ARIC）研究第4次和第6次访视以及辅助性认知的眼部决定因素（EyeDOC）研究的数据。我们纳入了年龄大于70岁的受试者，并提取了他们的性别、种族、居住地、家庭收入、教育水平、是否有眼科医生、健康保险状况、地区贫困指数（ADI）和视力结果。未矫正的VI被分类为未矫正的远距离视力损害（UDVI）或近距离视力损害（UNVI）。使用逻辑回归评估SDOH指标与VI之间的关联。
在967名成年人中（平均±标准差年龄，78.6±4.35岁；37.9%为男性），发现293例UDVI和186例UNVI。居住在密西西比州杰克逊市与UNVI的较低几率相关（调整后的优势比[aOR]=0.36；95%置信区间，0.20-0.65）。UNVI的较高几率与男性性别（aOR=2.01；95%置信区间，1.41-2.87）、低教育程度（未完成高中学业的aOR=2.32；95%置信区间，1.37-3.92；仅高中学历的aOR=1.92；95%置信区间，1.26-2.92）、没有眼科医生（aOR=1.58；95%置信区间，1.05-2.39）以及仅拥有政府医疗保险（aOR=1.48；95%置信区间，1.00-2.17）相关。SDOH因素与UDVI之间的关联较弱或不存在。
本研究将SDOH因素与老年人未矫正的VI联系起来。
在设计减少弱势群体中VI的干预措施时，应考虑SDOH。
