New research out of NORC at the University of Chicago sought to identify a potential association between self-reported and examination-based vision loss with social determinants of health (SDOH).
Tell me about the study.
Researchers performed a cross-sectional comparative study of three national surveys involving over 3.6 million individuals: the 2005-2008 National Health and Nutrition Examination Survey (NHANES), the 2019 American Community Survey (ACS), and the 2019 Behavioral Risk Factor Surveillance System (BRFSS).
The study used presenting visual acuity from the NHANES data for the closest comparison to self-reported vision loss and identified SDOH measures in each survey that aligned with those defined by the Office of the Assistant Secretary for Health (OASH) Healthy People 2030 SDOH concepts.
What were these measures?
The SDOH measures included:
- Economic stability (income, employment status, food security status)
- Education access and quality (educational attainment)
- Health care access and quality (health insurance; having a primary care physician or routine place to go for health care)
- Neighborhood and built environment (owning a home, urban or rural residence)
- Social and community context (marital status)
What did they find?
Across all three surveys, SDOH were found to be associated with vision loss.
Economic stability, in particular, was strongly associated with vision loss, while higher income, employment, and owning a home were linked with a lower likelihood of vision loss.
Limitations?
None of the data sets were longitudinal, and the ACS and BRFSS data were collected up to 10 years after the NHANES data set; furthermore, each survey was performed slightly differently, resulting in different age groups and the possibility that certain populations were excluded.
Takeaways.
In the invited commentary, Alex R. Kemper, MD, MPH, MS and colleagues point out that these findings are neither unexpected nor useful in a vacuum.
Social needs screening, they argue, is only as effective as its follow-up, and does not equate with evaluating SDOH or addressing them.
Ultimately, the commenters argue, the data provides further evidence for the importance of implementing public health policy expanding access to ophthalmology services.