We’ve talked about several different risk factors for vision loss on RYV – obesity, high blood pressure, and many other factors can heavily impact visual health. A recent study published by the CDC indicates that we may need to start talking about socioeconomic status in much the same way.
Previous studies focusing on vision loss have largely taken a large-scale approach to the issue, with epidemiologists comparing nations and states, rather than smaller geographic divisions. “Geographic Disparity of Severe Vision Loss” takes a different tack. The study, helmed by Karen Kirtland of the CDC’s Diabetes Translation division, instead compares individual counties in the US, allowing for a much more detailed examination of some of the factors that lie behind eye health.
The result: poverty appears to be a key indication of severe vision loss (SVL, defined in this study as blindness, or serious deficiencies even while wearing glasses). Poor regions of Southern States were vastly more likely to see high percentages of SVL, raising questions about the exact relationship between economic and visual well-being.
Vision Loss By Country
In order to get their data for county comparison, researchers used census data from 2009-2013 to find prevalence of vision loss and poverty in 3143 counties, which were then separated into categories based on both percentages of SVL and amount of population living below the poverty line.
The prevalence of both SVL and poverty were found to be much higher in Southern counties than they were in the West, Midwest, and Northeast. Of the counties in the top quartile of SVL prevalence, 77.3 percent were in the South, compared to 11.7 percent in the West, 10.7 percent in the Midwest, and only .3 percent in the Northeast.
Rates of poverty showed an extremely similar pattern and the results say 74.5 percent of counties that fit the study’s requirements for the highest category of poverty percentages were Southern, again followed by the West, Midwest, and finally Northeast.
Not only that, but the two metrics were found to have an extraordinarily tight correlation. Out of all the counties that were in the top category for SVL, 55.5 percent were also in the highest category for poverty. When the two were combined to create a new category for highest rates of both poverty and SVL, the South clearly lagged behind other regions, containing 83.1 percent of all counties in this category. Eight states in particular were likely to contribute to this count: Alabama, Arkansas, Georgia, Kentucky, Mississippi, North Carolina, Tennessee, and Texas all had unusually high rates of top-category counties in both vision loss and low socioeconomic status.
The Connection Between Poverty and Visual Health
It’s not exactly new to point to a connection between poverty and health problems, but the CDC’s study has driven the point home on how intimately visual health is linked to financial status. The report goes on to propose a number of reasons for this relationship.
First, the two are both components of a vicious cycle. It’s difficult to secure high-quality medical care with a low income, but that problem only stands to worsen when vision loss enters the equation. Severe vision loss can greatly impact a person’s ability to work and earn money, as most jobs, from manual labor to data entry, require at least some baseline of visual acuity.
Also mentioned is the effect that insurance has SVL prevalence. Many of the diseases that can cause vision loss are extremely preventable or manageable, and most can be detected by a full dilated eye exam. However, these services aren’t always within easy reach for people on Medicare, the go-to insurance solution for people over 65 without a personal or company plan.
Other Factors that Affect Vision
While only briefly mentioned in the actual report, several other lifestyle factors can affect visual health. Many of these also have a proven connection to poverty.
Smoking is an excellent example. Another CDC study on smoking rates among American adults found that roughly 29 percent of adults living below the poverty line smoked, compared to 16 percent of those who lived above it. While cigarettes aren’t exactly kind to any part of the body, they’re particularly hard on the eyes. Smokers are much more likely to contract age-related macular degeneration (AMD), cataracts, and glaucoma – the top three causes of preventable blindness.
Obesity is another serious player in vision loss and, again, one that’s tightly related to poverty. In the US, as opposed to many other countries, regions with high rates of poverty are also much more likely to have higher rates of obesity, according to a study conducted by the Mayoclinic’s James Levine. Bad news for eyes. Obese individuals often suffer from retinopathy, either because of blood pressure, or because of type II diabetes, which becomes much more likely in obese populations.
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What’s to be Done?
Kirtner’s report finishes with a few quick suggestions for future action based on her report’s findings. First, and in true researcher fashion, she emphasizes the need for further studies to fully investigate the connection she’s uncovered.
The conclusion also goes on to recommend healthier eating, the reduction of smoking rates, better education on eye health, and better access to eye care. Some of these issues are already seeing some attention; food deserts – areas in impoverished regions without access to healthy food – have become a better known phenomenon of late, and both policymakers and local activists have begun to look for ways to secure fresh food for people living in them.
Eye vitamins and similar low-cost health solutions may also have some promise moving forward. Further education about these options could make them valuable alternatives to expensive eye care in areas like the Southern counties explored by the CDC study.