State-level disparities in eye care utilization for adults with vision impairment

Purpose: To determine whether state-level race/ethnicity or socioeconomic status health disparities exist in eye care utilization among the people with visual impairment (VI). Design: Cross-sectional study. Methods: We used 2006-2009 Behavioral Risk Factor Surveillance System (BRFSS) from 21 states to assess state-level disparities in eye care utilization. We examined state-level disparities in yearly eye doctor visit by race/ethnicity, income, and education among adults with VI by two age groups (40-64 and 65+ years). Results: Among those aged 40-64 years, the proportion of adults with moderate to severe VI not having a yearly eye doctor visit ranged from a low of 39.4% (Colorado) to a high of 62.7% (Maryland). Among those aged 65+ years, the range was 64.7% (New Mexico) to 86.5% (Arizona). State-level race/ethnicity, income, and educational disparities exist in eye care utilization among people with VI. Among those aged 65+ years, the only states we did not find evidence of racial/ethnic disparities were Ohio, New York, and Kansas. Among those aged 40-64 years, we found evidence of racial disparities in all states except North Carolina and Wyoming. We found evidence of education disparities in all states except Kansas. We found evidence of income disparities among those with VI aged 65+ years in all states except Connecticut and Texas. Conclusion: Disparities exist in eye care among people with VI at the State level. States need to identify their vision health priorities and set up effective intervention programs.