Vision health disparities in the United States by race/ethnicity, education, and economic status: findings from two nationally representative surveys

Am J Ophthalmol. 2012 Dec;154(6 Suppl):S53-62.e1. doi: 10.1016/j.ajo.2011.08.045.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cataract / ethnology
  • Cross-Sectional Studies
  • Databases, Factual
  • Diabetic Retinopathy / ethnology
  • Educational Status*
  • Ethnicity*
  • Eye Diseases / ethnology*
  • Glaucoma / ethnology
  • Health Services / statistics & numerical data*
  • Health Services Accessibility
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Macular Degeneration / ethnology
  • Nutrition Surveys
  • Racial Groups*
  • Socioeconomic Factors*
  • United States / epidemiology