Population-Level Associations Between Visual Impairment and Functional Difficulties in California

ABSTRACT

Purpose

The prevalence of visual impairment is increasing, and there is a need to understand the functional implications. Using the American Community Survey (ACS) data, this study examined the relationship between visual impairment and functional difficulties in California.

Methods

Using the 2010–2014 and 2015–2019 ACS 5-year estimates from the U.S. Census, data were obtained for visual impairment and functional difficulties including hearing, cognitive, ambulatory, self-care, and independent living difficulties. The prevalence of vision impairment and each functional difficulty was calculated on the Medical Service Study Area (MSSA) level in California. Unadjusted and adjusted linear regression models were performed to estimate the association between visual impairment and each functional difficulty, adjusting for age, sex, race and ethnicity, education level, English-speaking ability, poverty status, health insurance status, and urbanity of residence location.

Results

The prevalence of visual impairment in California was 2.3% (659,502 of 28,794,572) in 2010–2014 and 2.3% (709,353 of 30,231,767) in 2015–2019 among the population ≥ 18 years old. There were statistically significant associations between the prevalence of vision impairment and increased prevalence of all functional difficulties, with the most positive correlation observed with ambulatory difficulty (slope estimate 0.58 ± 0.072 for 2010–2014 and 0.78 ± 0.082 for 2015–2019 for ambulatory difficulty).

Conclusions

There may be population-level impacts of functional consequences from vision impairment, suggesting the need for neighborhood-level investigation and policy-based interventions to address the burden of vision impairment on the population level.

KEYWORDS:

• Ambulatory difficulty
• function difficulty
• health outcomes
• low vision
• visual impairment

Acknowledgments

This submission has not been published anywhere previously and is not simultaneously being considered for any other publication. This paper was previously reviewed by Ophthalmic Epidemiology and reviewer comments and responses are attached.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/09286586.2024.2319243.

Additional information

Funding

This study was supported by an Unrestricted Grant from Research to Prevent Blindness to the UCLA Department of Ophthalmology.