Social Determinants of Health in Age-Related Macular Degeneration: A Nationally Representative Survey Study.

Abstract

To investigate the relationship between social determinants of health (SDoH) and the prevalence of age-related macular degeneration (AMD). This analysis included adult respondents (>50 years old) from the 2017 National Health Interview Survey (NHIS). The primary outcomes were self-reported diagnosis of AMD and self-reported vision loss due to AMD. Univariable and multivariable logistic regression models were employed for analysis. A total of 14,267 NHIS participants were included, of whom 668 (4.7%) reported an AMD diagnosis. In the multivariable analysis, respondents aged over 81 years had higher odds of AMD (OR=7.54, 95%CI=[4.76, 11.96], p<0.001) compared to those aged 51-60. Divorced, separated, or widowed participants (OR=1.27, 95%CI=[1.01, 1.61], p=0.042) were also associated with higher odds of AMD compared to married participants. Conversely, Black/African-American (OR=0.23, 95%CI=[0.14, 0.39], p<0.001), Asian (OR=0.38, 95%CI=[0.16, 0.88], p=0.023), and gay, lesbian, or bisexual respondents (OR=0.45, 95%CI=[0.22, 0.93], p=0.032) had lower odds of AMD compared to White and heterosexual respondents, respectively. Employment was also associated with lower odds of AMD (OR=0.71, 95%CI=[0.53, 0.96], p=0.026) compared to unemployment. Several SDoH were associated with self-reported AMD diagnosis. These factors should be considered by policymakers and clinicians to effectively orchestrate public health initiatives aimed at promoting equitable care.