Date of Award

Fall 1-8-2021

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr Ik Okosun

Second Advisor

Dr Reynolds Morrison



Background: Diabetic Retinopathy (DR) is one of the complications of diabetes and the primary cause of blindness among adults, and the third leading cause of all cases of blindness in the United States. DR is also the leading cause of vision loss, affecting over 100 million people worldwide. It accounts for 10,000 new cases of vision loss every year in the United States. Understanding the risk factors of diabetic retinopathy is crucial to the development of effective prevention strategies.

Aim: This study is designed to investigate the relationship between the selected independent variables and the risk of diabetic retinopathy among U.S. adults aged 40 years and above with diabetes.

Methods: Dataset from the 2017-2018 National Health and Nutrition Examination Survey (NHANES) was used for this study. The final sample comprised 893 adults aged 40 years and above with diabetes. Logistic regression analysis was used to determine the association between selected risk factors among those with diabetes and the risk of diabetic retinopathy. Results: Approximately 20% of the sample reported a diagnosis of DR Increased age (AOR=2.19, 95% CI:0.69 -7.06), female gender (AOR=1.81, 95% CI:0.71-4.41), and increased total cholesterol (AOR=2.83, 95% CI:1.030-27.3), Increase in BMI (AOR=1.71, 95% CI:0.23-12.88), blood pressure (AOR=1.40, 95% CI:0.41-4.75), Physical activity (AOR=1.37, 95% CI:0.41-4.60) and Non- Hispanic White(AOR=1.32, 95% CI:0.37-4.67) were found to be associated with greater odds of diabetic retinopathy after controlling for covariates.

Conclusion: Though not statistically significant, diabetic retinopathy was related to elevated total cholesterol, high BMI, an increase in age, and duration of diabetes. This study warrants the need for powered research to inform their relationship because of the lack of statistically significant association between the selected risk factors of diabetes and the risk of diabetic retinopathy.


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