title: Disparities in eye care utilization among the United States adults with visual impairment: findings from the behavioral risk factor surveillance system 2006-2009.
abstract: OBJECTIVE
  To estimate the prevalence of annual eye care among visually impaired United States residents aged 40 years or older, by state, race/ethnicity, education, and annual income.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  In analyses of 2006-2009 Behavioral Risk Factor Surveillance System data from 21 states, we used multivariate regression to estimate the state-level prevalence of yearly eye doctor visit in the study population by race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and other), annual income (≥$35,000 and <$35,000), and education (< high school, high school, and > high school).
  
  
  RESULTS
  The age-adjusted state-level prevalence of yearly eye doctor visits ranged from 48% (Missouri) to 69% (Maryland). In Alabama, Colorado, Indiana, Iowa, New Mexico, and North Carolina, the prevalence was significantly higher among respondents with more than a high school education than among those with a high school education or less (P < .05). The prevalence was positively associated with annual income levels in Alabama, Georgia, New Mexico, New York, Texas, and West Virginia and negatively associated with annual income levels in Massachusetts. After controlling for age, sex, race/ethnicity, education, and income, we also found significant disparities in the prevalence of yearly eye doctor visits among states.
  
  
  CONCLUSIONS
  Among visually impaired US residents aged 40 or older, the prevalence of yearly eye examinations varied significantly by race/ethnicity, income, and education, both overall and within states. Continued and possibly enhanced collection of eye care utilization data, such as we analyzed here, may help states address disparities in vision health and identify population groups most in need of intervention programs.
authors.affiliation: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3727, USA. CChou@cdc.gov
authors.forename: Chiu-Fang
authors.initials: CF
authors.lastname: Chou
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Barker
authors.forename: John E
authors.initials: JE
authors.lastname: Crews
authors.forename: Susan A
authors.initials: SA
authors.lastname: Primo
authors.forename: Xinzhi
authors.initials: X
authors.lastname: Zhang
authors.forename: Amanda F
authors.initials: AF
authors.lastname: Elliott
authors.forename: Kai
authors.initials: K
authors.lastname: McKeever Bullard
authors.forename: Linda S
authors.initials: LS
authors.lastname: Geiss
authors.forename: Jinan B
authors.initials: JB
authors.lastname: Saaddine
mesh_terms: D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D004522:Educational Status; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data*; D015995:Prevalence; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000191:economics / Q000208:ethnology / Q000628:therapy*; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*