Utilization of National Data to Address Vision Health Disparities: Pros and Cons

Purpose: To assess the usefulness of existing national surveys to address vision and eye health disparities. Design: Cross-sectional, nationally representative sample. Methods: We used data from National Health and Nutrition Examination Survey (NHANES) and National Health Interview Survey (NHIS). Estimates were weighted to represent the civilian, non-institutionalized US population using SAS and SUDDAN. Main outcome measures include age-related eye diseases (diabetic retinopathy [DR], age-related macular degeneration [AMD], cataract, and glaucoma) and eye care utilization. Results: In NHANES 2005-2008, non-Hispanic black individuals and Hispanic individuals were more likely to have DR compared to non-Hispanic white individuals (p<0.001 and p=0.005, respectively). Non-Hispanic white individuals were more likely to have cataract compared to non-Hispanic black individuals (p<0.001). Compared to their non-Hispanic white and Hispanic counterparts, non-Hispanic black individuals were less likely to have AMD (both p<0.001), but more likely to have glaucoma (both p<0.001). From 1999 to 2008, individuals with less education and lower income had consistently less access to eye care services (all p<0.001). Conclusions: A national surveillance system is necessary to assess and monitor long-term outcomes of improved prevention and control of eye diseases and vision loss, increased access to eye care, better quality of life for the visually impaired and enhanced vision health promotion throughout all life stages.