Dissertation Defenses

Doctoral Dissertation Announcement

---

Candidate: Amy L. Freeland

Degree of: Doctor of Philosophy

Department: Interdisciplinary Health Studies

Title: Visual Impairment and Eye Care among Older Americans:
Secondary Analysis of the Behavioral Risk Factor Surveil-lance System (BRFSS), Visual Impairment and Access to Eye Care Module and the Diabetes Module

Committee:
Dr. Robert Wall Emerson, Chair
Dr. Kieran Fogarty
Dr. John Crews

Date: Wednesday, March 11, 2009 2:00 p.m. - 4:00 p.m.
2073 College of Health and Human Services

Abstract:
National estimates of the population of people experiencing vision loss range from three million (over the age of 40) (Eye Diseases Prevalence Research Group, 2004) to 21 million (aged 18 and over) (Pleis & Lethbridge-Cejku, 2007). The lack of precision in estimating this population mirrors the lack of knowledge about the characteristics and behaviors of people who experience vision loss. Imprecise population estimates and lack of knowledge about the health behaviors in this population impede the development of rational policies and programs to serve them. In order describe current trends and then develop programs and policies to bridge gaps in access to care, population-based research is vital.
The aim of this three-paper format dissertation is to explore three issues relevant to public health dimensions of vision loss: (1) The first paper provides state-level examination of the characteristics of people aged 40 years and older with vision loss, self-reported eye diseases associated with aging, eye health care access, and behaviors in four states utilizing the Behavioral Risk Factor Surveillance System (BRFSS), Visual Impairment and Access to Eye Care Module in 2007. (2) The second paper examines three years of BRFSS data from 11 states to predict non-use of eye care based upon vision loss, diagnosed eye disease, and social demographic characteristics including possession of eye health insurance. (3) The third paper also examines three years of BRFSS data from 11 states but looks specifically at the sub-population of people with diagnosed diabetes. Using the Visual Impairment and Access to Eye Care Module as well as the Diabetes Module, researchers examined data in order to predict non-use of eye care based upon vision loss, diagnosed eye disease, social demographic characteristics and diabetes management habits. It was found that the strongest predictor of non-use was having no history of diagnosed eye disease, followed closely by not having insurance, and then by having a mid-range household income ($25,000-$35,000). Implications for public health practice are discussed.