Adapted from “United States’ Older Population and Vision Loss: A Briefing
by John D. Crews, PhD, Senior Scientist, VisionServe Alliance
September is Hispanic Heritage Month and Healthy Aging Month. VisionServe Alliance is focusing on both observances, highlighting Big Data Project findings relative to the United States’ Hispanic population aged 65+. According to the report 2018 Profile of Hispanic Americans Age 65 and Over from the Administration for Community Living, “the Hispanic American population (of any race) age 65 and over was 4,204,122 in 2017 and is projected to grow to 19.9 million by 2060.” This trend in the Hispanic older population is similar to the trends in America’s older population as a whole.
In Fall 2021, VisionServe Alliance (VSA) and The Ohio State University College of Optometry (OSU) partnered on the Big Data Project to analyze standardized statewide data and national reports of people who are blind or have low vision. When complete, the project will provide state-level data on the rate of blindness and low vision among people aged 65 years and older. These briefings also describe the rate of chronic conditions, quality of life, and disability indicators among older people with and without blindness and low vision. The data sets included in the project are the Behavioral Risk Factor Surveillance System (BRFSS) and the American Community Survey (ACS). Currently, state reports are available for California, Florida, Illinois, Louisiana, Missouri, New York, Oklahoma, and Pennsylvania, with additional states to be added throughout 2022.
Aging and Vision Loss in the United States
About 7.3% of older Americans report blindness or low vision. Women, African Americans, Hispanics, Native Americans, and the most elderly report higher prevalence of vision loss. Vision loss is not evenly distributed across the states. Of the eight pilot project states examined in early 2022, prevalence of blindness and low vision by state ranged from 5.8% to 12.4%.
Aging and Vision Loss among Hispanic Americans
At the national level, a breakdown of race/ethnicity of individuals who are visually impaired versus those not visually impaired in the U.S. indicates the prevalence of vision loss among Hispanics aged 65+ is twice that of Hispanics without vision loss.
Table 1. Prevalence of Blindness and Low Vision by Race/Ethnicity among People Age 65 Years and Older, U.S. (Source: BRFSS)
Social determinants of health (i.e., education, income and poverty, disability status, and health insurance) among Hispanic Americans age 65+ indicate a potential for poorer overall health, as well as increased disability (including vision loss) as compared to other populations in the U.S.
Table 2. Social Determinants of Health among the Hispanic American Population Age 65 and Over (Source: 2018 Profile of Hispanic Americans Age 65 and Over)
|Category||HispanicsAge 65+||United StatesAge 65+|
|Educational AttainmentHigh school diplomaBachelor’s degree or higher||57%14%||87%29%|
|Income (median income, 2017)||$40,512||$61,946|
|Health InsuranceBoth Medicare and supplemental private health insuranceCovered by both Medicare and Medicaid||25% 17%||46% 7%|
Impact of and Rehabilitation for Vision Loss
Blindness and low vision often have profound effects upon older people and those who care for and about them. Blindness and low vision can make common activities difficult or impossible; for example, climbing stairs, crossing a street, driving, using public transportation, preparing meals, and performing household activities may be compromised. Older people experiencing blindness and low vision may have difficulty managing accounts, paying bills, and identifying prescribed medications. Falls or fear of falling may further compromise their independence. Blindness and low vision often cause isolation, keeping people at home when they prefer to be with family and friends. Many older people with blindness and low vision do not interact with others who are going through the same experience, creating further isolation and depression. Many older people with blindness and low vision may wish to continue working, and some older people with vision loss serve as primary caregivers for other family members.
While the circumstances and risk factors associated with aging and blindness and low vision are serious, much can be done to ameliorate the effects of vision loss. For example, improved access and utilization of vision and eye health, as well as the availability of comprehensive vision rehabilitation services, promoting independence and autonomy, are effective strategies often enabling older people to live independently and remain active in their community.
A central component of supports for older people with blindness and low vision is a network of public and private agencies providing vision rehabilitation services addressing communication, activities of daily living, personal care, self-advocacy, travel and mobility skills, diabetes, and medication management, as well as access to assistive technology (e.g., smart phones, tablets, and computers). Services often include counseling, information, and referrals to community resources and supports. Vision rehabilitation services generally include low vision evaluations and the provision of adapted vision devices. Moreover, older people with blindness and low vision benefit from peer support groups where older people share common experiences and exchange information about successful management strategies. These services are often provided in the client’s home or in an agency setting. The sum of vision rehabilitation services improves independence, self-esteem, health, and quality of life.
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