Social inequalities in blindness and visual impairment: A review of social determinants

Ulldemolins, Anna Rius; Lansingh, Van C.; València, Laura Guisasola; Carter, Marissa J.; Eckert, Kristen A.

doi:10.4103/0301-4738.100529

Cited by 104 publications

(52 citation statements)

References 71 publications

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“…25,27,34 Previous study findings indicate that workers with low SEP are more likely than workers with high SEP to be employed in dangerous jobs and to be less likely to have access to safety equipment and other industrial protections. 34 Although studies have emphasized racial/ethnic differences in risk of sensory impairment, 10,18,24 our findings demonstrate that socioeconomic disparities in this health outcome are common among working-aged adults.…”

Section: Discussionmentioning

confidence: 56%

“…9,18,19,22 Damaging occupational exposures, such as high noise levels, could cause hearing impairment among farmers and construction workers, 4,25 and exposures such as sunlight, chemicals, and dust could cause vision impairment among farmers and blue-collar workers. 25,27,34 Previous study findings indicate that workers with low SEP are more likely than workers with high SEP to be employed in dangerous jobs and to be less likely to have access to safety equipment and other industrial protections.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 In both developed and developing countries, middle-aged and older people with low SEP were more likely than their more advantaged counterparts to have vision impairment 18–21 or hearing impairment. 22–27 Persons with low SEP lack the knowledge and resources necessary to protect themselves against the onset and progression of sensory impairment.…”

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confidence: 99%

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Association of Socioeconomic Position With Sensory Impairment Among US Working-Aged Adults

et al. 2015

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Objectives We examined the relationship between socioeconomic position (SEP) and sensory impairment. Methods We used data from the 2007 to 2010 National Health Interview Surveys (n = 69 845 adults). Multivariable logistic regressions estimated odds ratios (ORs) for associations of educational attainment, occupational class, and poverty–income ratio with impaired vision or hearing. Results Nearly 20% of respondents reported sensory impairment. Each SEP indicator was negatively associated with sensory impairment. Adjusted odds of vision impairment were significantly higher for farm workers (OR = 1.41; 95% confidence interval [CI] = 1.01, 2.02), people with some college (OR = 1.29; 95% CI = 1.16, 1.44) or less than a high school diploma (OR = 1.36; 95% CI = 1.19, 1.55), and people from poor (OR = 1.35; 95% CI = 1.20, 1.52), low-income (OR = 1.28; 95% CI = 1.14, 1.43), or middle-income (OR = 1.19; 95% CI = 1.07, 1.31) families than for the highest-SEP group. Odds of hearing impairment were significantly higher for people with some college or less education than for those with a college degree or more; for service groups, farmers, and blue-collar workers than for white-collar workers; and for people in poor families. Conclusions More research is needed to understand the SEP–sensory impairment association.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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Association of Socioeconomic Position With Sensory Impairment Among US Working-Aged Adults

et al. 2015

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“…Visual impairment (VI) is a worldwide problem with huge socio-economic consequences[ 5 ]. Individual low SES measured as low income, education or social class has been shown to be associated with VI in several studies[ 6 ]. At a population level, distribution of VI may be related to socio-economic factors[ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Composite Measures of Individual and Area-Level Socio-Economic Status Are Associated with Visual Impairment in Singapore

et al. 2015

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PurposeTo investigate the independent relationship of individual- and area-level socio-economic status (SES) with the presence and severity of visual impairment (VI) in an Asian population.MethodsCross-sectional data from 9993 Chinese, Malay and Indian adults aged 40–80 years who participated in the Singapore Epidemiology of eye Diseases (2004–2011) in Singapore. Based on the presenting visual acuity (PVA) in the better-seeing eye, VI was categorized into normal vision (logMAR≤0.30), low vision (logMAR>0.30<1.00), and blindness (logMAR≥1.00). Any VI was defined as low vision/blindness in the PVA of better-seeing eye. Individual-level low-SES was defined as a composite of primary-level education, monthly income<2000 SGD and residing in 1 or 2-room public apartment. An area-level SES was assessed using a socio-economic disadvantage index (SEDI), created using 12 variables from the 2010 Singapore census. A high SEDI score indicates a relatively poor SES. Associations between SES measures and presence and severity of VI were examined using multi-level, mixed-effects logistic and multinomial regression models.ResultsThe age-adjusted prevalence of any VI was 19.62% (low vision = 19%, blindness = 0.62%). Both individual- and area-level SES were positively associated with any VI and low vision after adjusting for confounders. The odds ratio (95% confidence interval) of any VI was 2.11(1.88–2.37) for low-SES and 1.07(1.02–1.13) per 1 standard deviation increase in SEDI. When stratified by unilateral/bilateral categories, while low SES showed significant associations with all categories, SEDI showed a significant association with bilateral low vision only. The association between low SES and any VI remained significant among all age, gender and ethnic sub-groups. Although a consistent positive association was observed between area-level SEDI and any VI, the associations were significant among participants aged 40–65 years and male.ConclusionIn this community-based sample of Asian adults, both individual- and area-level SES were independently associated with the presence and severity of VI.

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“…There were also trends for visual impairment in participants of lower social class and lower educational achievement level. A recently published review highlighted the evidence for the link between visual impairment and social class or education 23. Furthermore, it was reported recently that participants in the Los Angeles Latino Eye Study with incident visual impairment had spent less time in education, and were more likely to be unemployed 24…”

Section: Discussionmentioning

confidence: 99%

The EPIC-Norfolk Eye Study: rationale, methods and a cross-sectional analysis of visual impairment in a population-based cohort

Khawaja

Chan²,

Hayat

et al. 2013

BMJ Open

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ObjectivesTo summarise the methods of the European Prospective Investigation of Cancer (EPIC)-Norfolk Eye Study, and to present data on the prevalence of visual impairment and associations with visual impairment in the participants.DesignA population-based cross-sectional study nested within an on-going prospective cohort study (EPIC).SettingEast England population (the city of Norwich and its surrounding small towns and rural areas).ParticipantsA total of 8623 participants aged 48–92 years attended the Eye Study and underwent assessment of visual acuity, autorefraction, biometry, tonometry, corneal biomechanical measures, scanning laser polarimetry, confocal scanning laser ophthalmoscopy, fundal photography and automated perimetry.Outcome measuresVisual impairment was defined according to the WHO classification and the UK driving standard, and was based on presenting visual acuity. Summary measures of other ophthalmic measurements are also presented.ResultsThe prevalence (95% CI) of WHO-defined moderate-to-severe visual impairment and blindness was 0.74% (0.55% to 0.92%). The prevalence (95% CI) of presenting visual acuity worse than the UK driving standard was 5.87% (5.38% to 6.37%). Older age was significantly associated with visual impairment or blindness (p<0.001). Presenting visual acuity worse than UK driving standard was associated with older age (p<0.001), female sex (p=0.005) and lower educational level (p=0.022).ConclusionsThe prevalence of blindness and visual impairment in this selected population was low. Visual impairment was more likely in older participants, women and those with a lower educational level.

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Social inequalities in blindness and visual impairment: A review of social determinants

Cited by 104 publications

References 71 publications

Association of Socioeconomic Position With Sensory Impairment Among US Working-Aged Adults

Association of Socioeconomic Position With Sensory Impairment Among US Working-Aged Adults

Composite Measures of Individual and Area-Level Socio-Economic Status Are Associated with Visual Impairment in Singapore

The EPIC-Norfolk Eye Study: rationale, methods and a cross-sectional analysis of visual impairment in a population-based cohort

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