Disparities in Vision-Related Functional Impairments Among Adults in the United States

Purpose: To investigate the relationships between vision-related functional impairment (VFI) with sociodemographic and healthcare access factors in a representative sample of the United States population.

Methods: Data from the 2017 National Health Interview Survey (NHIS) were used. The NHIS involves responses from the U.S. civilian, non-institutionalized population aged 18 years or older. It provides self-reported data on demographic characteristics, socioeconomic factors, health status, and healthcare access. NHIS participants who responded to at least one of our target questions about VFI were included in the study. VFI was defined for participants based on their 'yes' or 'no' responses to target questions about experiencing a VFI. Data analysis was performed through univariable and multivariable logistic regression.

Results: Overall, 26,711 participants were included, of which 6926 (25.9%) participants reported experiencing a VFI. In univariable analysis, there were greater odds of VFI among females (OR: 1.16, 95% CI: 1.07-1.26, p < 0.001), and participants with less than a high school degree compared to those with an advanced degree (OR: 1.17, 95% CI: 1.02-1.33, p = 0.02). Among economic and healthcare access factors, greater odds of VFI was associated with public health insurance versus private coverage (OR: 1.19, 95% CI: 1.07-1.32, p = 0.001), having delayed medical care due to costs (OR: 1.86, 95% CI: 1.86-2.10, p < 0.001), and being unemployed (OR: 1.39, 95% CI: 1.26-1.53, p < 0.001). Participants whose incomes were lower than the poverty threshold (OR: 1.54, 95% CI: 1.32-1.80, p < 0.001) had higher odds of VFI than those with income >5× poverty threshold.

Conclusions: Several demographic and economic factors are associated with VFI in a representative sample of the U.S. population. These results highlight the importance of addressing social and economic factors that are associated with the development of VFI.