This study detected disparities in eye care for North American Natives. Photo: Getty Images.

A recent study found that North American natives, who make up 1.7% of the US population, have a higher prevalence of ophthalmic conditions than white individuals, yet there is no corresponding increase in services and treatment. The researchers noted that these disparities point to a need for policy changes and further research to determine contributing factors.

Data was gathered from the Vision and Eye Health Surveillance System, a publicly available resource listing Medicare claims across the country. Because North American natives and non-Hispanic whites older than 65 have similar Medicare coverage rates, the researchers used this dataset to compare claim rates for ophthalmic conditions and services between the two groups.

A total of 177,100 claims were filed for Native American natives and 24,438,000 for non-Hispanic whites. They found that higher condition claim rates but lower service claim rates were observed among North American natives vs. non-Hispanic whites for the following ophthalmic conditions: refractive errors, diabetic eye diseases, blindness and low vision, injury, burns, orbital and external disease and surgical complications of the eye. Despite this, service claim rates between the two racial groups were similar.

“In 16 of 17 ophthalmic condition categories and six of nine service categories, North American native individuals had significantly different claim rates from non-Hispanic white individuals,” the researchers wrote. The key findings are as follows:


North American Natives

Non-Hispanic Whites


Condition Claims

Service Claims

Condition Claims

Service Claims

refractive error

17.2

11.1

48.3

49.6

blindness, low vision

1.48

0.75

19.2

20.1

injury, burns, surgical complications

1.8

1.7

19.2

20.1

orbital and external disease

15.7

13.3

48.3

49.6

diabetic eye disease

5.22

2.2

14.4

14.8

 

Importantly, the researchers pointed out that there are no known genetic bases to account for the increased rate of eye diseases among this population. Rather, it is likely that the claim rate differences observed in this large database reveal substantial disparities in eye care access among North American native Medicare beneficiaries.

“Future research is needed to determine true prevalence rates of eye disease and eye care utilization in the North American native population, but North American native individuals with refractive errors, diabetic eye diseases and blindness/low vision are surmised to be in greatest need,” the researchers concluded.

Woodward MA, Hughes K, Ballouz D, et al. Assessing eye health and eye care needs among North American native individuals. JAMA Ophthalmol. December 23, 2021. [Epub ahead of print].