Date of Award

Spring 5-4-2021

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Kathleen M. Baggett

Second Advisor

Dr. Elizabeth Ann Mosley

Abstract

INTRODUCTION: Visual loss is a serious health, social and economic problem worldwide in the United States (U.S.), being a cause of morbidity and disability in society. Subsequently, low vision is high in developing countries, where social determinants of health (SDH) play a significant role in individuals' health status. Studies confirm the impact of SDH on low vision and access to visual healthcare in the U.S. Yet there is no recent research that addresses the relationship between income level, as a SDH and low vision in the U.S. at the national level.

AIM: This study aims to analyze income disparities in visual acuity using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2008 to verify the association between income level and low vision.

METHODS: This study is a population-based and nationally-representative, observational, secondary data analysis using information from NHANES (1999 – 2008) with a sample=27,200 adult participants. The study measured descriptive statistics, bivariate statistics (chi-squared), and logistic regression to compute the strength of association between the household income and visual acuity.

RESULTS: Lower-income subjects had significantly lower odds of normal vision (OR=0.822, p<0.05) and higher odds of low visual acuity (OR=1.214, p<0.05) and severe visual impairment (OR=1.44, p<0.05), compared to high-income level groups.

DISCUSSION: Low income is associated with lower likelihood of normal vision and higher risk of visual impairment. To improve disparities in visual health, economic inequality and its effects (for example, unequal access to health insurance and preventative visual healthcare) must be improved.

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