Hassan Hashemi, Reza Pakzad, Mohamadreza Aghamirsalim, Alireza Hashemi, Mehdi Khabazkhoob
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Abstract
Purpose: To investigate economic inequality in age-related macular degeneration (AMD) and decompose it into its determinants using Oaxaca-Blinder decomposition (OBD).
Methods: The Tehran Geriatric Eye Study was a cross-sectional study conducted on individuals aged 60 years and older, utilizing stratified random cluster sampling. Each participant received a comprehensive optometric, and slit-lamp examination. Diagnosis and classification of AMD were conducted utilizing fundus camera images.
Results: The data of the 3268 participants were analyzed. According to OBD, a significant difference was found in AMD between the rich and poor groups (8.36%) disfavoring the poor (p < 0.001). The explained and unexplained portions comprised 93.37% and 6.63% of the difference (p < 0.001 and p = 0.405, respectively). Among study variables, age (coefficient = 4.70; p < 0.001), economic status (coefficient = 3.58; p = 0.004), and myopia (coefficient = 0.73; p = 0.001) were significant determinants of inequality in the explained portion.
Conclusion: A significant disparity in the prevalence of AMD was observed between individuals of different socioeconomic statuses, primarily attributed to the explained factors. Factors such as age, economic status, and myopia were found to have the most substantial impact in exacerbating the inequality that disadvantaged the poor group (contributing percentages: 52.17%, 39.73%, and 8.10%, respectively). The findings of this research can be valuable for health policymakers in prioritizing and addressing the determinants of inequality within the population.
期刊介绍：
Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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