Disparities in Healthcare Access for Adults with Self-Reported Vision Difficulty - Behavioral Risk Factor Surveillance System 2019–2021

Abstract

ABSTRACT Purpose Identifying barriers experienced by individuals with vision difficulty (VD) in accessing healthcare is crucial to inform public health policies to provide equitable healthcare. We examined the association between VD with healthcare access measures in the United States (U.S.). Methods We used data on 1,258,919 participants surveyed from the 2019, 2020, and 2021 cycles of the Behavioral Risk Factor Surveillance System (BRFSS), a national telephone-based survey of U.S. adults ≥ 18 years. The following outcome of healthcare access were examined: no healthcare coverage, no healthcare provider, >1 year since last checkup, inability to afford healthcare. VD was self-reported blindness/serious difficulty seeing even when wearing glasses. Survey-weighted, multivariable logistic regression models were used to examine the relationship between VD and the outcomes of interest, adjusting for confounders. Results Of the 1,258,919 participants surveyed from 2019 to 2021, 5.1% reported having VD. Adjusted models showed that adults with VD had greater odds of having no healthcare coverage (OR = 1.14, 95% CI = 1.04-1.24), no provider (OR = 1.12; 95% CI = 1.05-1.20), a health checkup > 1 year ago (OR = 1.12; 95% CI = 1.04-1.21), and of being unable to afford care (OR = 1.62, 95% CI = 1.52-1.73). Conclusion Adults reporting VD faced more barriers accessing healthcare. These disparities could be explained by a differential distribution of social determinants of health, lack of accessibility of medical facilities and communication barriers. Policies aimed at strengthening provisions around accessibility of healthcare facilities might result in increased access to healthcare for this population.