Social determinants associated with loss of an eye in the United States using the All of Us nationwide database

ABSTRACT

Purpose

To identify common factors associated with the loss of an eye using the NIH All of Us database.

Methods

In this case-controlled study, we extracted electronic health record and socio-demographic data for 231 cases of eye loss from All of Us enrollment sites. Controls (N = 924) matched the demographic characteristics of the 2020 United States Census. Bivariate analyses and multivariable logistic regression identified variables significantly associated with increased odds of eye loss.

Outcome measures

Medical and social determinants associated with increased odds of losing an eye.

Results

Among cases, the average age (standard deviation) was 60.1 (14.4) years. The majority (125, 54.1%) were male. 87 (37.7%) identified as African American, and 49 (21.2%) identified as Hispanic or Latino. Loss of eye was more likely in those with ocular tumor (odds ratio [OR] 421.73, 25 95% confidence interval [CI] 129.81–1959.80, p < .001), trauma (OR 13.38, 95% CI 6.64–27.43, p < .001), infection (OR 11.46, 95% CI 4.11–32.26, p = .001) or glaucoma (OR 8.33, 95% CI 4.43– 15.81, p < .001). African American (OR 2.39, 95% CI 1.39–4.09, p = .002) and Hispanic or Latino (OR 1.80, 95% CI 1.01–3.15, p = .04) participants were disproportionately affected.

Conclusions

Racial and ethnic disparities exist among those with loss of an eye from underlying conditions. Addressing health inequities may mitigate the risk of this morbid outcome.

KEYWORDS:

• Big data
• enucleation
• health inequities
• loss of eye
• social determinants of health

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Acknowledgment

The All of Us Research Program is supported by the National Institutes of Health, Office of the Director: Regional Medical Centers: 1 OT2 OD026549; 1 OT2 OD026554; 1 OT2 OD026557; 1 OT2 OD026556; 1 OT2 OD026550; 1 OT2 OD 026552; 1 OT2 OD026553; 1 OT2 OD026548; 1 OT2 OD026551; 1 OT2 OD026555; IAA #: AOD 16037; Federally Qualified Health Centers: HHSN 263201600085U; Data and Research Center: 5 U2C OD023196; Biobank: 1 U24 OD023121; The Participant Center: U24 OD023176; Participant Technology Systems Center: 1 U24 OD023163; Communications and Engagement: 3 OT2 OD023205; 3 OT2 OD023206; and Community Partners: 1 OT2 OD025277; 3 OT2 OD025315; 1 OT2 OD025337; 1 OT2 OD025276. In addition, the All of Us Research Program would not be possible without the partnership of its participants.

Disclosure statement

No potential conflict of interest was reported by the author.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This study was supported by the National Institutes of Health (Bethesda, MD, Grant 1DP5OD029610) and an unrestricted departmental grant from Research to Prevent Blindness. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funders had no role in the design or conduct of this research.