Introduction:
Disparities exist in all fields of the healthcare system, including eye care. Global disparities in eye care persist, affecting vulnerable people in low- and middle-income countries. A health disparity is a difference in healthcare outcomes arising from health inequities affecting medically underserved populations.
A disparity in healthcare is the unfair distribution of health outcomes, determinants, and resources among a population based on several factors, such as social, economic, and environmental factors, limited access to trained professionals, and inadequate infrastructure. It is very important to eliminate health disparities to achieve health equity, where every individual has a fair opportunity to achieve their ideal health. Achieving the goal of health equality requires a multifaceted approach that combines awareness, investment, education, and innovation.
What Are the Disparities in Global Eye Care?
1. Race and Ethnicity - It is well known that individuals from racial and ethnic minority populations are more likely to have eye disorders leading to vision impairment and blindness. However, it is essential to understand that race is a socio-political construct, not a biological one, often defined differently. Studies have shown that black, Hispanic, Asian, and Native Americans have higher rates of vision problems when compared to white people. Additionally, Hispanic older adults and other ethnic minorities with vision problems are less likely to use vision aids when compared to white people. This inequality in eyecare is concerning because vision impairment is related to unemployment, affecting the affected individuals' economic status and overall health.
2. Age - Older people are commonly affected by vision issues and blindness. In the United States, old people with vision issues and blindness have been steadily increasing, and it is estimated that there will be a 25 percent increase in vision problems and a 21 percent increase in blindness by 2050. Older people with vision problems may face many serious challenges, including physical limitations, mental health issues, higher healthcare costs, and more major health conditions and death compared to those without vision problems.
3. Sex and Gender - According to a 2022 National Academies of Sciences, Engineering, and Medicine report, sex is a multidimensional construct based on anatomical and physiological traits, while gender is about personal identity and how people identify themselves socially. Regarding vision problems, recent studies suggest that women experience vision loss more than men, but the exact cause of this is unknown. Some researchers believe it is because women tend to live longer than men, along with some biological factors involved in certain eye conditions. However, in young populations, there is no difference between men and women.
4. Underlying Factors of Social Determinants of Health - The World Health Organization defines Social determinants of health (SDOH) as the conditions in which individuals are born, live, grow, work, and age. These conditions may be influenced by various facts about how money, power, and resources are distributed worldwide and locally.
Regarding eye health, factors like low income, insufficient food, low education levels, and living in unsafe neighborhoods can affect the chance of one getting vision problems. Children from families with low socioeconomic status are also more likely to have eyesight problems when compared to children from wealthier families. Low-income people cannot afford health insurance, which also affects vision care, as people without insurance are less likely to get eye care as needed.
5. Geographic location - Disparities in vision loss can also depend on where an individual lives. Some parts of the United States consistently have increased rates of eye problems, and this has been the case for a long time. Also, people living in cities, especially in areas with higher poverty levels, often report more vision problems.
How Can Disparities in Eye Care Be Eliminated in the Future?
1. Increasing Access to Eye Care:
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Federally Qualified Health Centers (FQHCs) - They can provide good eye care for individuals who struggle to get eye care, especially people from rural areas or with low incomes. However, 70 percent of the centers do not have on-site eye care professionals. It is essential to partner with FQHCs to offer eye care services that could make it easier for people to get the help they need.
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Teleophthalmology - Implicating teleophthalmology in areas without access to eye doctors could help more people get eye care.
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Patient Education - Educating patients about eye care is very important. They will know the importance of eyesight and the complications that can arise due to vision problems and blindness. This will help bring in new patients who have not seen an eye doctor before and make sure to revisit for future checkups.
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Insurance for Eye Care - Insurance covering eye care can help more people get the needed help and treatment. Some experts suggest that insurance should even cover things like glasses, eye examinations, and screening by eye specialists.
2. Affordability and Financial Support - Governments and NGOs can provide financial assistance or subsidize the cost of eye care services to people who cannot afford eye checkups and treatments. Health insurance schemes that cover eye care should be considered, and they can reduce financial barriers for people with low economic status. Also, ensure equitable access to services for all people.
3. Training and Capacity Building - Eye care professionals, including ophthalmologists, optometrists, and allied healthcare workers, should be provided with various eye care training that will keep them updated and help address the shortage of skilled personnel. Partnerships can do this with academic institutions, utilizing technology-enabled training platforms to enhance training quality and scalability.
4. Integration with Primary Health Care - Integrating primary health care infrastructure and eye care can improve accessibility for many individuals from rural and underdeveloped areas and ensure that eye health is prioritized within the broader healthcare system. Also, primary care providers should be offered proper training to screen for common eye conditions and provide basic treatments.
Conclusion:
Global disparities in eye care are still taking place and represent a significant public health challenge. By eliminating disparities in eye care, every individual can get improved eye care access without bias. To address the issues, the underlying barriers should be checked and accessed by raising awareness, leveraging technology and innovation, collaborating with governments, NGOs, and healthcare professionals, and investing in training and infrastructure so that everyone can get good vision care.
