Social deprivation tied to higher glaucoma risk

Personal poverty, as defined by not driving a personal vehicle to the appointment, and neighbourhood-level poverty appear to contribute to higher rates of screening positive for glaucoma or suspected glaucoma, suggests a study.

A total of 1,171 adults without acute ocular symptoms were included in this cross-sectional study from 2020 to 2022. The investigators summarized the participants’ sociodemographic characteristics and area deprivation index (ADI) values from the clinical sites, which included a free clinic and a federally qualified health centre (FQHC).

The ADI referred to a composite measure of neighbourhood deprivation (range, 1‒10, with 10 depicting worst deprivation). It was assigned based on the participants’ addresses.

The investigators performed group comparisons via 2-sample t tests or Wilcoxon Mann‒Whitney tests for continuous measures and chi-square tests or Fisher exact tests with Monte Carlo simulation for categorical measures. They also conducted multiple comparisons using Holm adjustment.

Of the participants, 1,165 (99.5 percent; mean age 55.1 years, 62 percent women, 54 percent Black, and 70 percent earned <$30,000 annually) completed the screening: 34 percent at the free clinic and 66 percent at the FQHC. The mean ADI was 7.2.

Participants in the FQHC had higher (worse) ADI than those in the free clinic (8.5 vs 4.5; p<0.0001). Nearly one in four participants (24 percent) screened positive for glaucoma or suspected glaucoma. Those who screened positive were more likely to be older (p=0.01), Black (p=0.0001), have an established eyecare clinician (p=0.0005), and not drive a personal vehicle to their appointment (p=0.001), which served as a proxy for increased poverty.

In addition, participants with a positive screening had worse ADI than those with a negative screening result (7.7 vs 7.0; p=0.002).

More White participants at the FQHC screened positive than their counterparts at the free clinic (21.3 percent vs 12.3 percent; p=0.01). White participants at the FQHC also had worse ADI than their free clinic counterparts (7.5 vs 3.7; p<0.0001).