Social determinants of health and health disparities in glaucoma: A review

Acuff, Kaela; Wu, Jo‐Hsuan; Varkhedi, Varsha; Baxter, Sally L.

doi:10.1111/ceo.14367

Clinical Exper Ophthalmology

2024

DOI: 10.1111/ceo.14367

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Social determinants of health and health disparities in glaucoma: A review

Kaela Acuff,

Jo‐Hsuan Wu,

Varsha Varkhedi

et al.

Abstract: Social determinants of health and barriers to care can significantly impact patients' access to glaucoma care and treatment, resulting in disparities within disease presentation, progression, management, and treatment outcomes. The widespread adoption of electronic health record systems has allowed researchers and clinicians to further explore these relationships, identifying factors such as race, ethnicity, and socioeconomic status to be risk factors for more severe disease and lower treatment adherence. Thes… Show more

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2024

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Cited by 3 publications

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The current landscape of social determinants of health in glaucoma (nature and nurture)

Sood,

Al‐Aswad

2024

Clinical Exper Ophthalmology

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The current landscape of social determinants of health in glaucoma (nature and nurture)

Sood,

Al‐Aswad

2024

Clinical Exper Ophthalmology

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Relationship between persistence with topical antiglaucomatous prescription and patient socioeconomic status at a tertiary university hospital in Jerez de la Frontera (Spain)

Pereira-Gonzalez,

Sanchez,

Carmona

et al. 2024

European Journal of Ophthalmology

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Introduction To study the relationship between socioeconomic status and persistence with topical antiglaucomatous medication. Methods A retrospective epidemiological observational cohort study was conducted with a sample of 1563 patients. The main dependent variable was persistence (medication possession ratio), the independent variable was socioeconomic status (deprivation index). Additional independent variables were used for multivariate analysis: individual health card index, sex, age, pharmacological group, number of eye drops, preservatives, diagnosis and concurrent medications. Bivariate statistical analysis was obtained using non-parametric tests. Logistic regression was used for multivariate analysis. The level of statistical significance was set at p < 0.05. Results We obtained data showing greater persistence in the groups with a higher socioeconomic level (deprivation index 1 and 2), with medication possession ratio values of 79.97 and 75.30, respectively) as opposed to the groups at lower socioeconomic levels (deprivation index 4 and 5, with medication possession ratio values of 73.75 and 69.85, respectively. Logistic regression corroborated this difference, reaching a significant value (no persistence in deprivation index group 5 versus 1) with OR = 1.62; 95%CI: 1.13–2.31. Additionally, lower persistence was detected in males, under 60 years of age, undergoing treatment with alpha-agonists, and in patients with ocular hypertension. Discussion Low socioeconomic status of the patient was significantly associated with decreased persistence with topical antiglaucomatous therapy.

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Racial and Gender Disparities for Glaucoma Treatment Rates in Upstate New York

Allison,

Hodges,

Shahid

et al. 2024

JCM

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Introduction: Glaucoma is one of the leading causes of irreversible blindness around the world. Black individuals are two times more likely to be diagnosed with glaucoma compared to White individuals. In 2019, the prevalence of glaucoma in Monroe County was highest amongst older individuals aged 85 and non-Hispanic Blacks. This study seeks to explore differences in glaucoma treatment rates that may be exacerbating disease severity and prognosis for individuals most acutely affected by glaucoma in Monroe County, NY. Methods: We used data from the Center for Disease Control’s National Vision and Eye Health Surveillance System (VEHSS) to assess the rates of glaucoma treatment for different racial, gender, and age demographic groups in Monroe County, NY. The source data were from individuals enrolled in Medicare who filed a claim. We stratified the data based on the glaucoma treatment type: laser glaucoma surgery, glaucoma drainage devices, other glaucoma surgery, or glaucoma prescription drugs. The main outcome variable was the prevalence rate of various types of glaucoma treatment in Monroe County, NY. The data were analyzed by potential risk covariates such as race/ethnicity, age, and gender. A descriptive data analysis was performed to assess for demographic trends. Results: The most common form of glaucoma treatment in Monroe County, NY was prescription drug therapy (36.82%), which was predominant across all racial, gender, and age groups. This was followed by laser surgery (3.26%), glaucoma drain (1.47%), and other forms of glaucoma surgery (0.58%). Women displayed a higher incidence of laser surgery, glaucoma drainage, and other glaucoma surgeries (3.58%, 1.77%, and 0.69%, respectively) with a lower incidence of prescription drug usage (36.14%) compared to men. Black non-Hispanic patients had a higher incidence of laser surgery and prescription drug usage (3.39% and 47.20%, respectively), but a lower incidence of glaucoma drainage and other glaucoma surgeries (1% and 0%, respectively) compared to other racial groups. Conclusions: This study elucidates the differences in glaucoma treatment types across different racial, gender, and age groups in Monroe County, NY. The results underscore the disparities in treatment rates for Medicare patients diagnosed with glaucoma in Monroe County. The results justify the need for increased interventions to increase access to a variety of glaucoma treatment options to mitigate disparities in glaucoma outcomes.

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Social determinants of health and health disparities in glaucoma: A review

Cited by 3 publications

References 188 publications

The current landscape of social determinants of health in glaucoma (nature and nurture)

The current landscape of social determinants of health in glaucoma (nature and nurture)

Relationship between persistence with topical antiglaucomatous prescription and patient socioeconomic status at a tertiary university hospital in Jerez de la Frontera (Spain)

Racial and Gender Disparities for Glaucoma Treatment Rates in Upstate New York

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