SOCIAL DETERMINANTS OF HEALTH IN AGE-RELATED MACULAR DEGENERATION: A Nationally Representative Survey Study.

Abstract

To investigate the relationship between social determinants of health and the prevalence of age-related macular degeneration (AMD). This analysis included adult respondents (≥50 years old) from the 2017 National Health Interview Survey. The primary outcomes were self-reported diagnosis of AMD and self-reported vision loss because of AMD. Univariable and multivariable logistic regression models were used for analysis. A total of 14,267 National Health Interview Survey participants were included, of whom 668 (4.7%) reported an AMD diagnosis. In the multivariable analysis, respondents aged over 81 years had higher odds of AMD (odds ratio [OR] = 7.54, 95% confidence interval [CI], 4.76-11.96, P < 0.001) compared with those aged 50 to 60. Divorced, separated, or widowed participants (OR = 1.27, 95% CI, 1.01-1.61, P = 0.042) also had a higher odds of AMD compared with married participants. Conversely, Black/African-American (OR = 0.23, 95% CI, 0.14-0.39, P < 0.001), Asian (OR = 0.38, 95% CI, 0.16-0.88, P = 0.023), and gay, lesbian, or bisexual respondents (OR = 0.45, 95% CI, 0.22-0.93, P = 0.032) had lower odds of AMD compared with White and heterosexual respondents, respectively. Employment was also associated with lower odds of AMD (OR = 0.71, 95% CI, 0.53-0.96, P = 0.026) compared with unemployment. Several social determinants of health were associated with self-reported AMD diagnosis. These factors should be considered by policymakers and clinicians to effectively orchestrate public health initiatives aimed at promoting equitable care.