Low Vision News

For low vision specialists and those who consult them

Americans with visual impairment have problems accessing healthcare

The most recent issue of Ophthalmic Epidemiology has an interesting paper by Spencer and colleagues on access to healthcare by people with visual impairment and blindness in the USA.

It shows quite elegantly that those who are visually impaired have more problems in accessing health care than those with good vision: 8.5% of those with visual impairment reported being unable to access necessary healthcare, compared to 4.6% of those who were legally blind, and 2.6% of those with good vision. Key barriers identified by those with visual impairment were cost, transportation, and insurance issues. Those who were legally blind experienced fewer difficulties than those with visual impairment (perhaps due to the extra benefits which blind certification entitles you to, such as supplementary security income and social security disability income). Legally blind people were, shockingly, more likely to be refused services.

This study was well conducted and corrected for differences in socio-economic status of those who are visually impaired (in this group, the visually impaired were more likely to be older, female, and unmarried than the group with good vision, for example). The study also has impressive statistical power: as a clinical researcher, I am always amazed when I see the number of subjects in most epidemiology papers (over 40,000 in this case).

As the US healthcare debate rumbles on, it is important to address problems with access to health services experienced by those with visual impairment. However, this study also raises wider problems with healthcare access – over 2.5% of people with good vision also report they are unable to get necessary medical care.


2 responses to “Americans with visual impairment have problems accessing healthcare

  1. G F Mueden November 3, 2009 at 3:31 am

    Interesting relationships, but not helpful until we know why people with low vision have that diffiuly.

    I am surprised that tis was overlooked. Did my old eyes not see it?


  2. lowvisionnews November 3, 2009 at 5:36 pm


    No, you didn’t overlook it. Epidemiology papers like this can look at trends and relationships between different factors with incredible power because of the very large numbers of data used – for example, they can show that people who live in town A are more likely to go blind than people in town B.

    What they can’t show is why this happens – although the authors can speculate as to reasons, different types of research are needed to identify the cause. In this case, qualitative research (perhaps open-ended interviews, or a questionnaire sent to those not receiving care).

    The good news is that these papers raise awareness of an issue so that other researchers then write grant applications and obtain funding to get to the bottom of the “why” questions.

    Best wishes

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