Joshua Uhr MD Ophthalmologist Philadelphia, PA

Ophthalmology: Identifying Racial and Socioeconomic Disparities in Eye Health Interview with:

Joshua Uhr MD Ophthalmologist Philadelphia, PA

Dr. Uhr

Joshua Uhr MD
Philadelphia, PA What is the background for this study?

Response: Disparities in American society have been at the forefront of the public consciousness in recent months. As part of the larger discussion about inequality, disparities in health outcomes have received much attention. In light of the renewed recognition that these disparities are stark and widespread, we felt it important to evaluate disparities in our own field, ophthalmology.

Previous studies have shown disparate outcomes for individual eye conditions, such as glaucoma, cataract, and retinal detachment. Although the common and relevant endpoint of these is visual impairment, few prior studies have examined disparities in visual impairment more broadly. Our aim was to provide an updated analysis of disparity in visual impairment among adults in the United States based on race and socioeconomic status. What are the main findings? 

Response: To that end, we assessed rates of self-reported visual impairment among more than 400,000 participants in the 2018 Behavioral Risk Factor Surveillance System, a national telephone survey administered by the CDC. In this large representative sample, minority race, lower educational attainment, lower income, and uninsured status were all associated with significantly higher rates of visual impairment. In a subgroup analysis of insured patients for whom data on insurance type was obtained, having non-private insurance or non-employer or union provided insurance were also associated with increased rates of visual impairment. The disproportionate burden of visual impairment in racial minority communities persisted even after controlling for socioeconomic status and medical comorbidities. What should readers take away from your report?

Response: Disparities are pervasive in all fields of medicine, and our study shows that ophthalmology is not immune.

In particular, we show that racial and socioeconomic disparities exist in rates of visual impairment in the United States. We hope that readers will take away an understanding (1) that these troubling trends exist, and (2) that more work needs to be done to address these unmet needs in population eye health. What recommendations do you have for future research as a result of this work? 

Response: Identifying and documenting disparities is an important first step, but the etiology of these disparities is complex and remains incompletely understood. Patient-level, provider-level, and healthcare systems-level factors are likely at play. Important directions for future research include further elucidating the drivers of disparities and, ultimately, developing and implementing strategies to mitigate disparities. Improving ophthalmic health equity is essential in our efforts to reduce the societal burden of visual impairment.

None of the authors have any financial interests to disclose.


Racial and Socioeconomic Disparities in Visual Impairment in the United States
Uhr, Joshua H. et al.

Ophthalmology, Volume 0, Issue 0



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Last Updated on November 9, 2020 by Marie Benz MD FAAD