Health Disparities in Lapses in Diabetic Retinopathy Care

Cai, Cindy X.; Tran, Diep; Tang, Tina; Liou, Wilson; Harrigian, Keith; Scott, Emily E.; Nagy, Paul; Kharrazi, Hadi; Crews, Deidra C.; Zeger, Scott L.

doi:10.1016/j.xops.2023.100295

Cited by 7 publications

(16 citation statements)

References 26 publications

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“…The outcome was a lapse in diabetic retinopathy care over 2 years . The main exposure was patient neighborhood socioeconomic disadvantage as measured by the 2019 area deprivation index (ADI) .…”

Section: Methodsmentioning

confidence: 99%

“…ADI was divided into quartiles (Qs), with Q4 indicating the most socioeconomic disadvantage. Baseline characteristics were extracted from the electronic health record, including race and ethnicity, other demographic data, clinic, residential distance from clinic, severity of diabetic retinopathy, other retinal disorders, and glaucoma . Multivariable logistic regression models were constructed to assess the association between ADI quartile and lapses in care, controlling for baseline characteristics.…”

Section: Methodsmentioning

confidence: 99%

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Place, Race, and Lapses in Diabetic Retinopathy Care

Tang,

Tran,

Han

et al. 2024

JAMA Ophthalmol

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Place, Race, and Lapses in Diabetic Retinopathy Care

Tang,

Tran,

Han

et al. 2024

JAMA Ophthalmol

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“… 4 , 5 Having poor housing and a greater burden of adverse SDoH have been associated with underutilization of eye care. 6 – 8 Adverse determinants have been linked with an increased risk of vision impairment. 9 , 10 One of the challenges of identifying the influence of specific determinates on health outcomes is that SDoH are inter-related and influence each other.…”

Section: Introductionmentioning

confidence: 99%

Social Risk Groups in Patients With Diabetes With Differing Eye Care Utilization and Vision Outcomes

Cai,

Han,

Tran

et al. 2024

Trans. Vis. Sci. Tech.

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Purpose To evaluate whether latent class analysis on social determinants of health (SDoH) data can identify social risk groups that differ by adverse SDoH and vision outcomes in patients with diabetes. Methods This was a prospective cohort study of adults ≥18 years with diabetes who completed a SDoH survey. Latent class analysis was used to cluster patients into social risk groups. The association of social risk group and severity of diabetic retinopathy, history of lapses in diabetic retinopathy care, and visual acuity was evaluated. Results A total of 1006 participants were included. The three social risk groups differed by sociodemographic characteristics. The average age was 65, 60, and 54 in Groups 1, 2, and 3 respectively. Most (51%) patients in group 1 were non-Hispanic White, 66% in group 2 were non-Hispanic Black, and 80% in group 3 were Hispanic. Group 1 had the lowest burden of adverse SDoH per person (average 3.6), group 2 had 8.2, and group 3 had 10.5. In general, group 1 lacked diabetic retinopathy knowledge, group 2 had financial insecurity and difficulties with transportation, and group 3 had financial insecurity and did not have health insurance. Social risk group was associated with a history of lapses in diabetic retinopathy care, and presenting with worse vision. Conclusions and Translational Relevance We identified distinct social risk groups among patients seeking care for diabetic retinopathy that differed by social needs, eye care utilization, and vision. Identifying these groups and their specific needs can help guide interventions to effectively address adverse SDoH and improve eye care utilization and vision outcomes among patients with diabetes.

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“…However, we are only beginning to identify and understand disparities in vision outcomes, risk for vision impairment, burden of severe disease, and eye care utilization. 1,2 At the core of health disparities, more broadly, are structural inequities that have led to the maldistribution of social determinants of health (SDOHs)-the social, economic, and physical conditions in which people live, work, and play that affect health outcomes. To date, much of the existing literature on health disparities in ophthalmology has focused on individual-level SDOHs particularly in the domains of economic stability, education access and quality, and health care access and quality.…”

mentioning

confidence: 99%

“…Ophthalmology is no exception. However, we are only beginning to identify and understand disparities in vision outcomes, risk for vision impairment, burden of severe disease, and eye care utilization . At the core of health disparities, more broadly, are structural inequities that have led to the maldistribution of social determinants of health (SDOHs)—the social, economic, and physical conditions in which people live, work, and play that affect health outcomes.…”

mentioning

confidence: 99%