|The higher rate of ocular disease and lower rate of treatment observed in American Indian and Alaskan Native populations highlights the social and health disparities faced by the two groups. Photo: Getty Images.
Examining the prevalence of ocular disease among different races and ethnicities can help highlight potential social and health disparities that certain groups face. American Indian and Alaskan Native individuals, for example, experience higher rates of diabetes, cardiovascular disease, cirrhosis and poor mental health compared with other races, which researchers have attributed to various social and health factors, including low socioeconomic status, disease burden and barriers to health services.
Investigators recently took a closer look at the prevalence of ocular pathologies in these two populations in the United States and Canada. Their retrospective cross-sectional study reviewed 14 articles from various databases reporting on the prevalence of eye diseases in American Indian and Alaskan Native populations. They found that these individuals had significantly increased rates of retinopathy, cataract, visual impairment and blindness. Both groups also had lower treatment rates and poorer outcomes in macular degeneration and glaucoma, though prevalence was similar in both American Indian and Alaskan Native and non-American Indian and Alaskan Native individuals.
“This review revealed trends in inequitable access of eye care where the prevalence rates of ophthalmologic conditions are much higher in American Indians and Alaskan Natives, yet the rates of treatment are much lower than non-American Indians and Alaskan Natives, demonstrating a continued need for eye care serving the American Indian and Alaskan Native community,” the researchers wrote in their study, published in the American Journal of Ophthalmology.
The team pointed out that there may also be significant underreporting of common ophthalmic conditions among American Indian and Alaskan Native populations due to a lack of literature on eye disease in the two groups. Additionally, many of the studies included in the present review involved telephone-administered surveys and self-reported conditions from interviews, “both of which may obscure true rates of prevalence for the disease due to underreporting and disparate access to telephone services, as well as lower health literacy in marginalized communities,” the researchers explained.
This research suggests indigenous populations face increased rates of several of the most common eye diseases for reasons likely linked to social and health disparities. “Future research is necessary to explore whether lack of access to care is a cause of disparate health outcomes and to determine the appropriate systemic and policy changes necessary for the improvement of eye health for all American Indian and Alaska Native communities,” the researchers concluded in their paper.
Miller AM, Gill MK. A review of the prevalence of ophthalmologic diseases in native American populations. Am J Ophthalmol. June 16, 2023. [Epub ahead of print].