Healthcare access gaps in adults with vision difficulty
Reviewed by Hannah Thomsett

The authors analyse data from the Behavioral Risk Factor Surveillance System (2019–2021) to evaluate disparities in healthcare access among adults with self-reported vision difficulty. This large cross-sectional study demonstrates that individuals reporting visual impairment face significant barriers across multiple domains of care. Compared to those without vision difficulty, affected individuals were less likely to access routine healthcare services and more likely to report cost-related barriers, delayed care and lack of insurance coverage. Preventative service uptake was also reduced, highlighting a broader pattern of unmet healthcare needs. Importantly, these disparities persisted after adjustment for demographic and socioeconomic factors, suggesting that vision difficulty itself contributes independently to reduced healthcare access. The study further identifies that these inequities disproportionately affect already vulnerable populations, including those with lower income and educational attainment, compounding existing health inequalities. Strengths include the large, nationally representative dataset and the use of recent multi-year data, enhancing generalisability. However, reliance on self-reported vision difficulty may introduce misclassification bias, and the cross-sectional design limits causal inference. Additionally, unmeasured confounders may influence access patterns. Despite these limitations, the findings highlight an important public health issue and emphasise the need for targeted interventions to improve healthcare accessibility for visually impaired adults. The study is particularly relevant for service planning and policy development aimed at reducing inequities in care delivery.

Disparities in healthcare access for adults with self-reported vision difficulty - behavioral risk factor surveillance system 2019–2021.
Onukwugha C, Castro F, Swenor BK, Varadaraj V. 
OPHTHALMIC EPIDEMIOLOGY
2024;33(1):103–8.