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  • Author
    Karissa Wang
  • PI

    Bartly Mondino

  • Co-Author

    Victoria L. Tseng, Deyu Pan, Fei Yu, Anne L. Coleman

  • Title

    Association between visual impairment and health-related outcomes in California

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  • Other Program (if not listed above)

  • Abstract

                 Visual impairment is a term encompassing conditions of low vision such as partial vision loss and blurry vision not improved with refractive correction, as well as complete blindness. The high prevalence and increasing incidence of visual impairment presents a public health concern due to its associations with increased mortality and higher risk for depression and anxiety. This project uses the American Community Survey data sets from the U.S. census to examine the relationship between visual impairment and several health-related outcomes in California.

                Using the 2015-2019 American Community Survey (ACS) 5-year estimates from the U.S. census, data were obtained for visual impairment and several health-related outcomes, including hearing difficulty, cognitive difficulty, ambulatory difficulty, self-care difficulty, and independent living difficulty. The ACS is a continuous nationwide survey conducted by the U.S. Census Bureau to collect social, economic, housing, and demographic data about the individuals living in the United States. Participants who responded positively to the corresponding survey questions were considered to experience each health-related difficulty. The unit of analysis were Medical Service Study Areas (MSSAs), which are geographic areas for healthcare professional shortages and medically underserved populations recognized by the US Health Resources and Services Administration. The prevalence of each health-related variable was calculated for each MSSA in California as the number of residents experiencing each health-related difficulty per 100 residents. Additionally, unadjusted and adjusted linear regression models were performed at the MSSA level to estimate the association between visual impairment and each health-related outcome, both for the population ≥ 18 years of age or older and again for the population ≥ 65 years of age or older.

                The total population of California who were 18 years or older in the 2015-2019 ACS was 30,231,767 and the population who were 65 years or older was 5,478,957. There were 542 MSSAs in California. The overall prevalence of visual impairment in CA was 2.3% in the population ≥ 18 years and 6.1% in the population ≥ 65 years, respectively. There were statistically significant associations between the prevalence of vision impairment and the prevalence of all examined health-related outcomes in both populations, with the strongest associations seen with the ambulatory difficulty. In the population ≥ 18 years, each 1% increase in the prevalence of visual impairment was associated with a 1.57±0.090% (slope estimate ± SE) increase in the prevalence of ambulatory difficulty in the unadjusted model and a 0.98±0.081% increase in the adjusted model after adjusting for the covariates. In the population ≥ 65 years, each 1% increase in visual impairment was associated with a 1.49±0.074% increase in ambulatory difficulty in the unadjusted model and a 1.08±0.080% increase in the adjusted model.

                In the 2015-2019 ACS population, higher prevalence of visual impairment may be associated with higher prevalence of health-related outcomes including ambulatory difficulty, independent living difficulty, cognitive difficulty, hearing difficulty, and self-care difficulty.

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