Table 3:
The association of each social determinants of health (SDoH) variable with eye care utilization in the past 12 months.
| No eye care utilization | Eye care utilization | Unadjusted | Adjusted* | |||
|---|---|---|---|---|---|---|
| N (Weighted %) | N (Weighted %) | OR (%95 CI) | p value | OR (95% CI) | p value | |
| Economic Stability | ||||||
| Never or previously employed | 5491 (58) | 8199 (64) | 1.25 (1.16, 1.35) | <0.001 | 0.85 (0.78, 0.93) | 0.001 |
| No sick leave | 3895 (48) | 4563 (40) | 0.71 (0.65, 0.77) | <0.001 | 0.75 (0.69, 0.81) | <0.001 |
| Low family income | 5548 (62) | 6039 (48) | 0.55 (0.51, 0.6) | <0.001 | 0.54 (0.49, 0.59) | <0.001 |
| Difficulty paying medical bills | 2034 (24) | 1955 (17) | 0.64 (0.58, 0.7) | <0.001 | 0.71 (0.64, 0.79) | <0.001 |
| Unable to pay medical bills | 1214 (59) | 1062 (54) | 0.83 (0.69, 0.99) | 0.035 | 0.83 (0.68, 1.00) | 0.047 |
| High Financial Distress Composite Score | 2551 (32) | 2573 (23) | 0.63 (0.58, 0.69) | <0.001 | 0.74 (0.67, 0.81) | <0.001 |
| Cost-related medication nonadherence | 1353 (19) | 1262 (11) | 0.54 (0.48, 0.61) | <0.001 | 0.61 (0.54, 0.69) | <0.001 |
| Foregone/delayed care due to cost | 1938 (22) | 1669 (15) | 0.60 (0.55, 0.66) | <0.001 | 0.67 (0.61, 0.75) | <0.001 |
| Neighborhood, physical environment, and social cohesion | ||||||
| Renting (vs. owned home) | 3667 (37) | 3858 (27) | 0.62 (0.57, 0.67) | <0.001 | 0.72 (0.66, 0.79) | <0.001 |
| Disagree: people in neighborhood help each other | 1918 (24) | 2186 (18) | 0.73 (0.67, 0.79) | <0.001 | 0.79 (0.72, 0.87) | <0.001 |
| Disagree: people in neighborhood can be trusted | 1867 (23) | 2007 (16) | 0.66 (0.60, 0.72) | <0.001 | 0.74 (0.67, 0.82) | <0.001 |
| Disagree: this is a close-knit neighborhood | 3208 (40) | 4212 (36) | 0.85 (0.79, 0.91) | <0.001 | 0.90 (0.84, 0.97) | 0.008 |
| Disagree: people in neighborhood I can count on | 1820 (23) | 2054 (17) | 0.69 (0.63, 0.76) | <0.001 | 0.78 (0.71, 0.86) | <0.001 |
| Community and social context | ||||||
| Psychological distress (Kessler K6 Scale) | 671 (8) | 693 (6) | 0.70 (0.60, 0.80) | <0.001 | 0.76 (0.64, 0.88) | 0.001 |
| Food Insecurity | ||||||
| Food Insecurity | 1614 (17) | 1502 (11) | 0.58 (0.52, 0.64) | <0.001 | 0.65 (0.58, 0.73) | <0.001 |
| Education | ||||||
| English language proficiency (not well/not at all) | 722 (10) | 672 (6) | 0.60 (0.52, 0.7) | <0.001 | 0.66 (0.55, 0.81) | <0.001 |
| <=High school | 4042 (41) | 4431 (32) | 0.69 (0.64, 0.74) | <0.001 | 0.66 (0.61, 0.72) | <0.001 |
| Health Information Technology use: Did not look up health info on internet | 5780 (64) | 7349 (58) | 0.76 (0.70, .83) | <0.001 | 0.67 (0.61, 0.73) | <0.001 |
| Health Information Technology use: Filled a prescription online | 7879 (91) | 10598 (87) | 0.63 (0.55, 0.71) | <0.001 | 0.60 (0.52, 0.70) | <0.001 |
| Health Information Technology use: Scheduled a healthcare appointment online | 8053 (93) | 11012 (90) | 0.65 (0.55, 0.76) | <0.001 | 0.60 (0.50, 0.71) | <0.001 |
| Health Information Technology use: Communicated with healthcare provider online | 7912 (91) | 10638 (87) | 0.62 (0.54, 0.71) | <0.001 | 0.58 (0.50, 0.67) | <0.001 |
| Health Information Technology use: Used internet chat rooms to learn about health | 8280 (97) | 11644 (96) | 0.79 (0.63, 1.00) | 0.047 | 0.73 (0.57, 0.93) | 0.01 |
| Health care system | ||||||
| Uninsured | 984 (12) | 371 (3) | 0.25 (0.21, 0.29) | <0.001 | 0.33 (0.28, 0.39) | <0.001 |
| No usual source of care | 561 (7) | 221 (2) | 0.27 (0.22, 0.33) | <0.001 | 0.35 (0.28, 0.44) | <0.001 |
| Trouble finding a doctor/provider in past 12 months | 344 (4) | 350 (3) | 0.72 (0.59, 0.88) | 0.002 | 0.77 (0.62, 0.95) | 0.015 |
| MD’s office does not accept you as new patient in past 12 months | 280 (3) | 349 (3) | 0.97 (0.80, 1.17) | 0.726 | 1.06 (0.87, 1.30) | 0.58 |
| MD’s office does not accept your insurance in past 12 months | 341 (4) | 446 (4) | 0.99 (0.82, 1.18) | 0.897 | 1.11 (0.92, 1.35) | 0.266 |
| Delayed medical care: couldn’t get through on phone | 293 (3) | 415 (4) | 1.07 (0.87, 1.32) | 0.513 | 1.15 (0.93, 1.44) | 0.198 |
| Delayed medical care: couldn’t get appointment soon enough | 680 (8) | 989 (9) | 1.03 (0.90, 1.18) | 0.687 | 1.10 (0.95, 1.26) | 0.206 |
| Delayed medical care: wait too long at MD’s office | 582 (7) | 694 (6) | 0.89 (0.76, 1.04) | 0.137 | 0.96 (0.81, 1.13) | 0.632 |
| Delayed medical care: not open when you could go | 293 (4) | 402 (4) | 0.98 (0.78, 1.22) | 0.855 | 1.05 (0.83, 1.33) | 0.665 |
| Delayed medical care: no transportation | 427 (4) | 480 (3) | 0.80 (0.67, 0.95) | 0.011 | 0.80 (0.66, 0.96) | 0.019 |
| Somewhat/very dissatisfied (quality) or no healthcare in past year | 1065 (14) | 734 (6) | 0.42 (0.37, 0.48) | <0.001 | 0.48 (0.42, 0.56) | <0.001 |
Abbreviations: OR = odds ratio; CI = confidence interval
*
Adjusted by age, sex, race/ethnicity, geographic region, Charlson Comorbidity Index, year of the survey, and vision impairment.