The Impact of Social Determinants of Health on Vision Loss from Cataracts and Cataract Surgery Utilization in the United States: Analysis of Three National Health Interview Survey Years, 2008, 2016, 2017.

PURPOSE: To investigate the association of social determinants of health (SDOH) factors and cataract-related outcomes disparities.

DESIGN: Cross-sectional, with a nationally representative sample.

METHODS: We used publicly available data from the 2008, 2016, and 2017 National Health Interview Survey datasets. Outcome measures included self-reported prevalence for ever been diagnosed with cataract, vision loss secondary to cataracts, and likelihood of undergoing cataract surgery. Survey-weighted, multivariable logistic regression models, adjusted for age, race/ethnicity, and other relevant covariates, were used to examine the association between SDOH factors and cataract-related outcomes.

RESULTS: 81,551 participants were included, who were predominantly between 18 to 44 years (49.6%), female (51.7%), and White (74.8%). Multivariable regression models with age as a covariate showed that individuals who were not working were more likely to report having cataracts compared to those who were working (P < .001). Those who needed but could not afford medical care in the past year were more likely to report vision loss secondary to cataracts compared to their counterparts (P < .001). Uninsured participants were less likely to report undergoing cataract surgery compared to those with private insurance (P = .03). Individuals with higher income (poverty-income ratio [PIR] 1.00-2.99 vs <1.00) were more likely to report undergoing cataract surgery (P = .04).

CONCLUSIONS: Several SDOH factors were associated with disparities in rates of cataract-related outcomes. These findings highlight the importance of ophthalmologists screening for social risks in patients with cataract, as these social factors are important barriers for access to care.