• Natalie Lo

Inequities in Ophthalmology

Updated: Apr 17

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World in Focus is dedicated to raising awareness and combating injustices in ophthalmology. It is important to understand and be aware of the social inequities in healthcare that are caused by the social determinants of health, especially relating to ophthalmology, blindness, as well as steps that can be taken to reduce them.

Image: https://lehmanmeridian.squarespace.com/articles/2020/6/5/income-gap-in-healthcare-exposes-gender-inequities


First, we have to understand what the social determinants of health are. In the same way that biological factors like viruses cause disease, socioeconomic factors are also large determinants of health. The socioeconomic determinants of health include gender, socioeconomic status, ethnicity and race, housing situation, geographic region, and disabilities. How do social determinants of health actually have an impact? Let’s look at the example of geographic regions. In rural areas, medical professionals are few and far between. On Indigenous reserves in the North, doctors are scarce, so individuals must travel far beyond their reserve, which is extremely difficult, in order to receive medical treatment. The burden of long commute times impacts their ability to receive adequate healthcare, and therefore, impacts their health.


The social determinant of health that most directly influences the rate of blindness is poverty and socioeconomic status. Studies from France and the United States have shown that people with lower vision had less income. For example, the monthly household income in France for those with vision problems was a mere 1255€, while those without vision problems earned an average of 1851€. In the most economically disadvantaged neighbourhoods in the US and Australia, an increased rate of visual problems was documented, and the prevalence of blindness in low-income countries is much higher than those in high income countries. Thus, it can be said that there is a direct relationship between a country's GDP and blindness rate, suggesting an intertwined cycle of visual impairment and poverty. Studies from Europe show that the visual impaired were at a higher risk of unemployment, receiving inadequate salaries, and less opportunities than their visually privileged coworkers. In France, individuals with no vision impairment have jobs that pay 5 times more than those given to people who suffer from blindness.


What can be done to solve this problem? Raising awareness about the inequities that the visually impaired endure is a great starting point. In becoming more educated about these issues, we can break the silence surrounding inequity in ophthalmology. Likewise, more funding and research dedicated to understanding the social and biological impacts that lead to these inequities must be done in order to arrive at a better solution for these issues. Supporting organizations like World in Focus, who aim to promote equality in ophthalmology allow us to aid those who are affected by them. Ultimately, we need to raise enough awareness about this issue so that governments around the world can put policies into place that will ultimately result in positive change and end the cycle of visual impairment and poverty.


Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491260/#ref50

https://jamanetwork.com/article.aspx?doi=10.1001/archopht.123.8.1117

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