The Importance of Health Literacy in Addressing Eye Health and Eye Care Disparities

Capó, Hilda; Edmond, Jane; Alabiad, Chrisfouad R.; Ross, Ahmara G.; Williams, Basil K.; Briceño, César A.

doi:10.1016/j.ophtha.2022.06.034

Cited by 13 publications

(16 citation statements)

References 41 publications

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“…29,30 Furthermore, poorer health literacy has been shown to adversely affect eye health, with lower health literacy documented in ethnic/ racial groups, the elderly, populations with lower educational attainment, and those from socioeconomically disadvantaged backgrounds. 31 At 1 year and 2 years, Medicaid-insured patients had a smaller improvement in VA than privately insured patients across all races (Figure 2, B and C; Figure 3). These data suggest that insurance status impacts VA outcomes.…”

Section: Discussionmentioning

confidence: 95%

Effect of Race and Insurance Status on Treatment and Outcomes in Diabetic Retinopathy: Analysis of 43 274 Eyes Using the IRIS Registry

Maturi,

Scott

et al. 2024

Journal of VitreoRetinal Diseases

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Purpose: To examine disparities in visual acuity (VA) outcomes 1 year and 2 years after initiation of diabetic retinopathy (DR) or diabetic macular edema (DME) treatment in patients based on race/ethnicity and insurance status, accounting for disease severity. Methods: This retrospective analysis used the IRIS Registry and included DR patients older than 18 years with documented antivascular endothelial growth factor (anti-VEGF) treatment and VA data for at least 2 years. International Classification of Diseases, Tenth Revision, Clinical Modification codes were used to determine the severity of DR and DME presence. VA outcomes were assessed using multivariable linear regressions and anti-VEGF drug use by multivariable logistic regressions, with race and insurance status as independent variables. Main outcome measures comprised the mean VA change at 1 year and 2 years and percentage of patients treated with bevacizumab. Results: Among 43 274 eyes, White patients presented with a higher mean VA and lower mean DR severity than Black and Hispanic patients. Multivariable logistic regression showed Hispanic patients were significantly more likely to be treated with bevacizumab than White patients across all insurance types, controlling for disease severity and VA. After 1 year, the letter improvement was 1.73, 1.33, and 1.13 in White, Black, and Hispanic patients, respectively. Multivariable linear regression suggested that across races, Medicaid-insured patients had significantly smaller gains in VA than privately insured patients. Conclusion: Race-based and insurance-based differences in 1-year and 2-year outcomes after anti-VEGF treatment for DR and anti-VEGF treatment patterns suggest a need to ensure earlier and more effective treatment of minority and underserved patients nationally.

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Section: Discussionmentioning

confidence: 95%

Effect of Race and Insurance Status on Treatment and Outcomes in Diabetic Retinopathy: Analysis of 43 274 Eyes Using the IRIS Registry

Maturi,

Scott

et al. 2024

Journal of VitreoRetinal Diseases

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“…Awareness of eye diseases and risk factors is lacking, however. 38,39 It is unreasonable to expect patients to act on information they lack, nor is it fair for providers to assume that patients will independently seek this knowledge. Consequently, community outreach should prioritize enhancing vision health literacy, equipping patients with the essential information they need to make informed decisions about their care.…”

Section: Policy and Public Health Recommendationsmentioning

confidence: 99%

“…Consequently, community outreach should prioritize enhancing vision health literacy, equipping patients with the essential information they need to make informed decisions about their care. [38][39][40]…”

Section: Policy and Public Health Recommendationsmentioning

confidence: 99%

Factors Influencing Vision Health and Eye Care among Older Adults in Northeast Tennessee

Southerland,

Elahi,

Zheng

et al. 2024

Southern Medical Journal

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“…Suggestions for improving access include expanding Medicare and Medicaid coverage, developing school-based vision screenings and expanding teleophthalmology [10 ▪▪ ]. Access to eye care is also influenced by health literacy and language barriers, as well as the cultural competency of providers [11 ▪▪ ]. For example, poor health literacy has been linked to increased rates of diabetic retinopathy and lower adherence to therapy in glaucoma patients.…”

Section: Improving Access To Eye Carementioning

confidence: 99%

“…For example, poor health literacy has been linked to increased rates of diabetic retinopathy and lower adherence to therapy in glaucoma patients. Ophthalmologists can increase awareness of eye diseases and management among vulnerable communities by ensuring that educational materials are written at an appropriate reading level to be easily understood [11 ▪▪ ]. Improved health education and literacy can ultimately reduce inequities in eye health and alleviate barriers to access.…”

Section: Improving Access To Eye Carementioning

confidence: 99%

Diversity, equity and inclusion in ophthalmology

Aguwa

Williams

Woreta

2023

Current Opinion in Ophthalmology

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Purpose of review Diversity, equity and inclusion (DEI) initiatives in ophthalmology have received increased attention in recent years. This review will highlight disparities, barriers to workforce diversity, as well as current and future efforts to improve DEI in ophthalmology. Recent findings Racial, ethnic, socioeconomic and sex disparities exist in vision health and across many ophthalmology subspecialties. The pervasive disparities result from factors such as a lack of access to eye care. In addition, ophthalmology is one of the least diverse specialties at the resident and faculty level. The lack of diversity has also been documented in ophthalmology clinical trials, wherein participant demographics do not reflect the diversity of the U.S. population. Summary Addressing social determinants of health including racism and discrimination is necessary to promote equity in vision health. Diversifying the workforce and expanding the representation of marginalized groups in clinical research are also paramount. Supporting existing programmes and creating new ones focusing on improving workforce diversity and reducing eye care disparities are essential to ensure equity in vision health for all Americans.

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The Importance of Health Literacy in Addressing Eye Health and Eye Care Disparities

Cited by 13 publications

References 41 publications

Effect of Race and Insurance Status on Treatment and Outcomes in Diabetic Retinopathy: Analysis of 43 274 Eyes Using the IRIS Registry

Effect of Race and Insurance Status on Treatment and Outcomes in Diabetic Retinopathy: Analysis of 43 274 Eyes Using the IRIS Registry

Factors Influencing Vision Health and Eye Care among Older Adults in Northeast Tennessee

Diversity, equity and inclusion in ophthalmology

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