Delayed or Forgone Healthcare Due to COVID-19 among Adults with Vision Impairment

ABSTRACT

Introduction

Decreased public transit, no‑visitor policies, and other restrictions to reduce the spread of COVID‑19 may limit healthcare access for vision impaired adults. This study aimed to assess rates of healthcare delayed or forgone due to COVID‑19 among adults with low vision.

Methods

Data were analyzed from the 2021 National Health Interview Survey, a representative sample of US adults. Vision and hearing impairment were determined by self‑report. The primary study outcome was delayed or canceled medical care due to COVID‑19. Multivariable logistic regression models adjusted for gender, age, race, education, insurance, income, region, and chronic comorbidities were constructed to examine associations of medical care delayed due to COVID‑19.

Results

Overall, 1.6% (n=457) of adults had vision impairment and 1.6% (n=438) had hearing impairment. Vision impairment was not associated with having taken a COVID‑19 test (P=0.34) or previous COVID‑19 infection (P=0.46). Adults with vs without low vision had higher rates of delayed (30.7% vs 19.2%, 1.86 [1.43-2.42], P<.0001) and cancelled care due to COVID-19 (23.9% vs 12.2%, 2.21 [1.66-2.94], P<.0001). Even compared to adults with hearing impairment, those with vision impairment were more likely to report canceled medical care due to COVID‑19 (1.20 [1.02-1.41], P=0.03).

Conclusion

Adults with low vision had increased risk of delayed and canceled medical care due to COVID‑19, with increased rates of canceled medical care even when compared to those with hearing impairment. These results suggest COVID‑19 and interventions to limit its spread have had a disproportionate impact on adults with low vision and place them at risk of poor health outcomes.

KEYWORDS:

• Ophthalmology
• low vision
• COVID-19
• epidemiology
• healthcare access

Abbreviations used

US=United States; NHIS=National Health Interview Survey; aOR=adjusted odds ratio; CI=confidence interval.

Ethical Approval

This study adhered to all tenets of the Declaration of Helsinki.

Statement of Informed Consent

The Northwestern University Institutional Review Board determined this does not constitute human subjects research because all data were publicly available online and informed consent was not required.

Disclosure statement

No potential conflict of interests were reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.