Study: Researchers investigate gaps in health inequities in underserved areas

Deficient ophthalmologic care is costly to patients, making the identification of groups not receiving adequate care of vital importance.

A team of researchers, led by Christian Hemmerich, BS, from the Office of Medical Student Research, Oklahoma State University Center for Health Sciences, and the Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, reported research gaps regarding health inequities that were “substantial” in association with the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, and race and ethnicity, and the role of telemedicine in rural and under-resourced areas in the US.¹

"The current landscape of equity in ophthalmic care has yet to be thoroughly investigated and is important to ensure inclusivity and patient-centered care," according to investigators.

Hemmerich reported that the team searched the literature from 2016 to 2021. The search modeled the NIH’s list of designated US health inequity populations and included income, education level, occupational status, rural and under-resourced areas, LGBTQ identity, and race and ethnicity, the last of which included American Indian and Alaska Native, Asian, and Native Hawaiian and other Pacific Islander individuals.

The articles were included if they were ophthalmic studies that discussed health inequities.

Ultimately, of 8170 abstracts and titles screened in the review, 75 publications were included.

“Notable inequities were found among Black and Hispanic patients associated with negative ophthalmic outcomes and mixed associations regarding sex or gender,” investigators pointed out. “Overall, lower-income patients were more likely to have vision impairment, use eye care services less, and have lower adherence to eye examinations.”

The results did not identify any articles that examined LGBTQ inequities among ophthalmology patients since the 2016 NIH classification of sexual and gender minority populations.

The study identified substantial research gaps in the ophthalmic literature regarding the LGBTQ community, race and ethnicity, and rural and under-resourced areas.

“Because of the importance of ophthalmic care in overall patient health, it is vital to understand the various inequities present and strive to improve the current gaps in the literature,” investigators concluded. “Future studies should (1) examine barriers to clinical study and medical trainee recruitment as well as patient values and preference studies and (2) investigate the implementation of telemedicine in under-resourced areas.”

Reference

Hemmerich C, Jones G, Staggs J, et al. Inequities and research gaps in ophthalmology. A scoping review. JAMA Ophthalmol. Published online December 8, 2022. doi:10.1001/jamaophthalmol.2022.5237