Social Determinants of Health Data Availability for Patients with Eye Conditions

Lee, Terrence C.; Saseendrakumar, Bharanidharan Radha; Nayak, Mahasweta; Chan, Alison; McDermott, John J.; Shahrvini, Bita; Ye, Gordon Y; Sitapati, Amy M.; Nebeker, Camille; Baxter, Sally L.

doi:10.1016/j.xops.2022.100151

Cited by 19 publications

(20 citation statements)

References 32 publications

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“…A key position paper by the American Academy of Ophthalmology (AAO) published in 2022 summarized the impact SDOH has on vision health and discussed the importance of increasing community participation and developing meaningful relationships with the populations we serve ]. More research needs to be conducted on SDOH to increase understanding of which particular factors have the greatest impact on patients' health outcomes and to identify ways to mitigate them [8]. Improved trainee education about SDOH is also another necessary step to improve clinician knowledge.…”

Section: Disparities In Eye Care and Social Determinantsmentioning

confidence: 99%

“…Expanding community-based eye care by partnering with trusted community sites or local health fairs are examples of effective methods of community engagement [7 ▪ ]. More research needs to be conducted on SDOH to increase understanding of which particular factors have the greatest impact on patients’ health outcomes and to identify ways to mitigate them [8]. Improved trainee education about SDOH is also another necessary step to improve clinician knowledge.…”

Section: Disparities In Eye Care and Social Determinantsmentioning

confidence: 99%

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Diversity, equity and inclusion in ophthalmology

Aguwa

Williams

Woreta

2023

Current Opinion in Ophthalmology

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Purpose of review Diversity, equity and inclusion (DEI) initiatives in ophthalmology have received increased attention in recent years. This review will highlight disparities, barriers to workforce diversity, as well as current and future efforts to improve DEI in ophthalmology. Recent findings Racial, ethnic, socioeconomic and sex disparities exist in vision health and across many ophthalmology subspecialties. The pervasive disparities result from factors such as a lack of access to eye care. In addition, ophthalmology is one of the least diverse specialties at the resident and faculty level. The lack of diversity has also been documented in ophthalmology clinical trials, wherein participant demographics do not reflect the diversity of the U.S. population. Summary Addressing social determinants of health including racism and discrimination is necessary to promote equity in vision health. Diversifying the workforce and expanding the representation of marginalized groups in clinical research are also paramount. Supporting existing programmes and creating new ones focusing on improving workforce diversity and reducing eye care disparities are essential to ensure equity in vision health for all Americans.

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Section: Disparities In Eye Care and Social Determinantsmentioning

confidence: 99%

Section: Disparities In Eye Care and Social Determinantsmentioning

confidence: 99%

Diversity, equity and inclusion in ophthalmology

Aguwa

Williams

Woreta

2023

Current Opinion in Ophthalmology

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“…Chronic conditions require long-term care, and SRFs often inhibit consistent care. SRFs have been linked to worse outcomes and vision loss in the US for glaucoma, diabetic retinopathy, age-related macular degeneration, cataracts, and uncorrected refractive error but have not been thoroughly explored for anterior segment diseases including microbial keratitis (MK). MK affects 1.5 to 2 million people globally every year causing acute, severe vision impairment and blindness .…”

Section: Introductionmentioning

confidence: 99%

Social Risk Factor Associations With Presenting Visual Acuity in Patients With Microbial Keratitis

et al. 2023

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ImportanceNeighborhood-level social risk factors may contribute to health disparities in microbial keratitis (MK) disease presentation. Understanding neighborhood-level factors may identify areas for revised health policies to address inequities that impact eye health.ObjectiveTo investigate if social risk factors were associated with presenting best-corrected visual acuity (BCVA) for patients with MK.Design, Setting, and ParticipantsThis was a cross-sectional study of patients with a diagnosis of MK. Patients presenting to the University of Michigan with a diagnosis of MK between August 1, 2012, and February 28, 2021, were included in the study. Patient data were obtained from the University of Michigan electronic health record.Main Outcomes and MeasuresIndividual-level characteristics (age, self-reported sex, self-reported race and ethnicity), presenting log of the minimum angle of resolution (logMAR) BCVA, and neighborhood-level factors, including measures on deprivation, inequity, housing burden, and transportation at the census block group, were obtained. Univariate associations of presenting BCVA (&lt; 20/40 vs ≥20/40) with individual-level characteristics were assessed with 2-sample t, Wilcoxon, and χ2 tests. Logistic regression was used to test associations of neighborhood-level characteristics with the probability of presenting BCVA worse than 20/40 after adjustment for patient demographics.ResultsA total of 2990 patients with MK were identified and included in the study. Patients had a mean (SD) age of 48.6 (21.3) years, and 1723 were female (57.6%). Patients self-identified with the following race and ethnicity categories: 132 Asian (4.5%), 228 Black (7.8%), 99 Hispanic (3.5%), 2763 non-Hispanic (96.5%), 2463 White (84.4%), and 95 other (3.3%; included any race not previously listed). Presenting BCVA had a median (IQR) value of 0.40 (0.10-1.48) logMAR units (Snellen equivalent, 20/50 [20/25-20/600]), and 1508 of 2798 patients (53.9%) presented with BCVA worse than 20/40. Patients presenting with logMAR BCVA less than 20/40 were older than those who presented with 20/40 or higher (mean difference, 14.7 years; 95% CI, 13.3-16.1; P &lt; .001). Furthermore, a larger percentage of male vs female sex patients presented with logMAR BCVA less than 20/40 (difference, 5.2%; 95% CI, 1.5-8.9; P = .04), as well as Black race (difference, 25.7%; 95% CI, 15.0%-36.5%;P &lt; .001) and White race (difference, 22.6%; 95% CI, 13.9%-31.3%; P &lt; .001) vs Asian race, and non-Hispanic vs Hispanic ethnicity (difference, 14.6%; 95% CI, 4.5%-24.8%; P = .04). After adjusting for age, self-reported sex, and self-reported race and ethnicity, worse Area Deprivation Index (odds ratio [OR], 1.30 per 10-unit increase; 95% CI, 1.25-1.35; P &lt; .001), increased segregation (OR, 1.44 per 0.1-unit increase in Theil H index; 95% CI, 1.30-1.61; P &lt; .001), higher percentage of households with no car (OR, 1.25 per 1 percentage point increase; 95% CI, 1.12-1.40; P = .001), and lower average number of cars per household (OR, 1.56 per 1 less car; 95% CI, 1.21-2.02; P = .003) were associated with increased odds of presenting BCVA worse than 20/40.Conclusion and RelevanceFindings of this cross-sectional study suggest that in a sample of patients with MK, patient characteristics and where they live were associated with disease severity at presentation. These findings may inform future research on social risk factors and patients with MK.

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“…Currently, we are forced to turn to neighborhood-level data from sources, such as the American Community Survey because individuallevel SDOH data are not often collected as part of routine care. 7 As such, there exists a major need to assess SDOHs at the point of care. Such individual-level data may not only inform decision-making for the treating health care professional, but could also build an improved understanding of the relationship between the patients and their communities.…”

mentioning

confidence: 99%

“…The challenge of translating neighborhood-level to individual-level factors (and vice versa) highlights a substantial limitation in health disparities research. Currently, we are forced to turn to neighborhood-level data from sources, such as the American Community Survey because individual-level SDOH data are not often collected as part of routine care . As such, there exists a major need to assess SDOHs at the point of care.…”

mentioning

confidence: 99%