Eye Examination Recency among African American Older Adults with Chronic Medical Conditions
<i>Background:</i> Pervasive racial and economic inequalities have a disproportionate impact on health care utilization among African Americans. One area where we see such disparities is in the recency of eye examinations among the economically disadvantaged. However, our current underst...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-04-01
|
| Series: | Healthcare |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9032/8/2/94 |
| _version_ | 1797570838066626560 |
|---|---|
| author | Mohsen Bazargan Tavonia Ekwegh Sharon Cobb Edward Adinkrah Shervin Assari |
| author_facet | Mohsen Bazargan Tavonia Ekwegh Sharon Cobb Edward Adinkrah Shervin Assari |
| author_sort | Mohsen Bazargan |
| collection | DOAJ |
| description | <i>Background:</i> Pervasive racial and economic inequalities have a disproportionate impact on health care utilization among African Americans. One area where we see such disparities is in the recency of eye examinations among the economically disadvantaged. However, our current understanding of the barriers and facilitators of eye examinations in underserved African-American older adults is limited. <i>Aims:</i> Building on Andersen’s model of health service use and using an exploratory approach; we tested various demographic, social, and health factors that were associated with eye examination among underserved middle-aged and older adults in South Los Angeles. We examined predisposing characteristics, enabling factors, and need-for-care characteristics. <i>Methods:</i> With a cross-sectional design, we conducted this survey on a convenience sample of (<i>n</i> = 740) non-institutionalized African-American older adults who were 55+ years old and residing in South Los Angeles, CA, USA. Data were collected on demographic factors, continuity of care, access to care, self-rated health, chronic medical conditions, and depressive symptoms. The outcome was recency of eye examination. Multivariate regression was used for data analysis. <i>Results:</i> 59% of the participants had received at least one eye examination during the last 12 months. A total of 17% had an eye examination within the last two years. Notably, 26% of diabetic participants did not have an eye examination within the last two years. One out of four participants indicated that, within the last two years, no provider ever recommended that they receive an eye examination. Age, education, continuity of medical care, accessibility of medical care, satisfaction with medical care, providers’ recommendation for eye examination, self-rated health, and a diagnosis of hypertension and diabetes mellitus were predictors of eye examination recency. Overall, our analysis indicates that these enabling factors accounted for most of the variance in the recency of eye examinations. <i>Conclusion:</i> A large proportion of underserved African-American middle-aged and older adults in South Los Angeles do not comply with the recommended annual eye examination. This is, in part, because about one-third of them have not received an eye exam recommendation from their health care providers. However, a wide range of factors such as age, education, continuity of care, satisfaction with access, self-rated health, and a diagnosis of hypertension and diabetes mellitus, also influence whether or not African-American middle-aged and older adults receive an eye examination. Programs should address a wide range of multi-level factors to tackle this health inequality. |
| first_indexed | 2024-03-10T20:31:07Z |
| format | Article |
| id | doaj.art-86155e1218094525bca4bd2c70db6278 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T20:31:07Z |
| publishDate | 2020-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-86155e1218094525bca4bd2c70db62782023-11-19T21:25:07ZengMDPI AGHealthcare2227-90322020-04-01829410.3390/healthcare8020094Eye Examination Recency among African American Older Adults with Chronic Medical ConditionsMohsen Bazargan0Tavonia Ekwegh1Sharon Cobb2Edward Adinkrah3Shervin Assari4Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USASchool of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, CA 90059, USADepartment of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USADepartment of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USADepartment of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA<i>Background:</i> Pervasive racial and economic inequalities have a disproportionate impact on health care utilization among African Americans. One area where we see such disparities is in the recency of eye examinations among the economically disadvantaged. However, our current understanding of the barriers and facilitators of eye examinations in underserved African-American older adults is limited. <i>Aims:</i> Building on Andersen’s model of health service use and using an exploratory approach; we tested various demographic, social, and health factors that were associated with eye examination among underserved middle-aged and older adults in South Los Angeles. We examined predisposing characteristics, enabling factors, and need-for-care characteristics. <i>Methods:</i> With a cross-sectional design, we conducted this survey on a convenience sample of (<i>n</i> = 740) non-institutionalized African-American older adults who were 55+ years old and residing in South Los Angeles, CA, USA. Data were collected on demographic factors, continuity of care, access to care, self-rated health, chronic medical conditions, and depressive symptoms. The outcome was recency of eye examination. Multivariate regression was used for data analysis. <i>Results:</i> 59% of the participants had received at least one eye examination during the last 12 months. A total of 17% had an eye examination within the last two years. Notably, 26% of diabetic participants did not have an eye examination within the last two years. One out of four participants indicated that, within the last two years, no provider ever recommended that they receive an eye examination. Age, education, continuity of medical care, accessibility of medical care, satisfaction with medical care, providers’ recommendation for eye examination, self-rated health, and a diagnosis of hypertension and diabetes mellitus were predictors of eye examination recency. Overall, our analysis indicates that these enabling factors accounted for most of the variance in the recency of eye examinations. <i>Conclusion:</i> A large proportion of underserved African-American middle-aged and older adults in South Los Angeles do not comply with the recommended annual eye examination. This is, in part, because about one-third of them have not received an eye exam recommendation from their health care providers. However, a wide range of factors such as age, education, continuity of care, satisfaction with access, self-rated health, and a diagnosis of hypertension and diabetes mellitus, also influence whether or not African-American middle-aged and older adults receive an eye examination. Programs should address a wide range of multi-level factors to tackle this health inequality.https://www.mdpi.com/2227-9032/8/2/94health care usehealth servicesAfrican-Americansethnic groupshealth disparitieseye examination |
| spellingShingle | Mohsen Bazargan Tavonia Ekwegh Sharon Cobb Edward Adinkrah Shervin Assari Eye Examination Recency among African American Older Adults with Chronic Medical Conditions Healthcare health care use health services African-Americans ethnic groups health disparities eye examination |
| title | Eye Examination Recency among African American Older Adults with Chronic Medical Conditions |
| title_full | Eye Examination Recency among African American Older Adults with Chronic Medical Conditions |
| title_fullStr | Eye Examination Recency among African American Older Adults with Chronic Medical Conditions |
| title_full_unstemmed | Eye Examination Recency among African American Older Adults with Chronic Medical Conditions |
| title_short | Eye Examination Recency among African American Older Adults with Chronic Medical Conditions |
| title_sort | eye examination recency among african american older adults with chronic medical conditions |
| topic | health care use health services African-Americans ethnic groups health disparities eye examination |
| url | https://www.mdpi.com/2227-9032/8/2/94 |
| work_keys_str_mv | AT mohsenbazargan eyeexaminationrecencyamongafricanamericanolderadultswithchronicmedicalconditions AT tavoniaekwegh eyeexaminationrecencyamongafricanamericanolderadultswithchronicmedicalconditions AT sharoncobb eyeexaminationrecencyamongafricanamericanolderadultswithchronicmedicalconditions AT edwardadinkrah eyeexaminationrecencyamongafricanamericanolderadultswithchronicmedicalconditions AT shervinassari eyeexaminationrecencyamongafricanamericanolderadultswithchronicmedicalconditions |