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Significant racial disparity seen in low vision device use by Medicare beneficiaries
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Older adults in the U.S. from minority ethnic groups reported less use of low vision devices compared to white individuals.
In the cross-sectional survey, researchers determined whether sociodemographic or economic factors were associated with self-reported use of low vision devices or low vision rehabilitation.
Participants included 3,058 Medicare beneficiaries 65 years and older with self-reported vision impairment from the National Health Interview Survey vision supplement from the 2002, 2008 and 2016 data.
Low vision device users were significantly older and more likely to be white than nonusers, while vision rehabilitation users were older than nonusers.
For Hispanic individuals, the adjusted odds ratio of using a low vision device was significantly lower, at 0.61, and the odds ratio for individuals of other races/ethnicities was 0.39.
Researchers found no significant difference in the likelihood of reporting vision rehabilitation between racial/ethnic groups.
Black, Hispanic and adults of other races/ethnicities were all less likely to report using low vision devices.
Additionally, they reported that low vision device use was not significantly associated with sex, educational attainment or income as a percent of the federal poverty level in any of the study models.
“If the associations from this study are confirmed, coverage of low vision devices by Medicare may help address a significant health care disparity in the use of this evidence-based intervention,” researchers wrote. – by Abigail Sutton
Disclosures: Choi reported no relevant financial disclosures. Please see the full study for all remaining authors’ financial disclosures.
Perspective
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Louis A. Frank, OD, FAAO
In the concluding remarks of this study of disparities in low vision device use among minority populations within the Medicare system, the authors state that, “policymakers could consider expanding Medicare coverage to include low vision devices in an effort to address significant disparities in the use of this evidence-based intervention.”
It is historically as well as linguistically reasonable that minority Medicare eligible populations lived through several eras in which their communities received little if any health education in school; health care was neglected, ignored, or entirely insufficient. According to the U.S Census Bureau as cited by a 2012 Prevent Blindness America report, 77% of Asian Americans speak another language at home, while 70% of Hispanics speak Spanish at home. Upon reaching Medicare eligibility (age 65 years), the inability to understand Medicare regulations or plans could indeed be expected to create disparities in access of and utilization of Medicare plans, a situation that is compounded by vision impairment.
Policymakers should consider expanding Medicare coverage for low vision devices because the ultimate cost of treating the depression, potential isolation and self-neglect that is known to occur when the visually impaired are not using their remaining vision would far exceed the cost of such a program to the government. Access to low vision devices, regardless of the socioeconomic data considered herein, would enable Medicare recipients to retain a meaningful quality of life, effectively monitor their own medications, stay connected to society, perhaps remain in their homes and potentially retain their independence.
Reference:
Prevent Blindness America. Focus on eye health and culturally diverse populations. 2012.
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