The Association between Socioeconomic Factors and Visual Function among Patients with Age-Related Cataracts

Abstract

Background. With the development of the economy, socioeconomic factors, such as inequalities in the status of regional economies and the subsequent effects on health systems, have influenced the status of health. We explored the association between age-related cataracts and socioeconomic indicators, including the regional economy, health systems, and energy industries. Methods. This was a prospective, multicenter, Chinese population-based, cross-sectional study. A total of 830 participants from seven centers were enrolled. Data on the best-corrected visual acuity (BCVA), Lens Opacities Classification System III (LOCS III) score, Visual Function Index-14 (VF-14) score, total and subscale scores of the 25-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25), per capita disposable income (PCDI), medical resource-related indicators, and investments in the energy industry were obtained. Associations among these parameters were analyzed. Results. The PCDI ranking was correlated with the VF-14 score (R = −0.426, $P<0.01$ ), total score of NEI-VFQ-25 (r = −0.500, $P<0.01$ ), and BCVA (r = 0.278, $P<0.01$ ). The number of health agencies (r1 = 0.267, r2 = −0.303, r3 = −0.291,), practicing or assistant practicing doctors (r1 = -0.283, r2 = 0.427, r3 = 0.502,), registered nurses (r1 = −0.289, r2 = 0.409, r3 = 0.469, $P<0.01$ ), and health technicians (r1 = −0.278, r2 = 0.426, r3 = 0.500, $P<0.01$ ) per 10,000 of the population was each correlated with the BCVA, VF-14 score, and total score of NEI-VFQ-25, respectively. Health expenditure per capita was correlated with the VF-14 score (r = 0.287, $P<0.01$ ) and total score of NEI-VFQ-25 (r = 0.459, $P<0.01$ ). The LOCS III P score was correlated with investments in the energy industry (r = 0.485, $P<0.001$ ). Conclusions. Patients in higher economic regions with greater medical resources show a greater demand to undergo cataract surgery at a better subjective and objective visual function. The energy industry has a significant effect on cataracts, especially the posterior subcapsular cataract, and thus more attention should be paid to people in regions with abundant energy industries.