Educational inequalities in the prevalence of vision impairment among older adults in India: A decomposition analysis

Background

Vision impairment (VI) in the elderly is a significant health challenge, leading to functional limitations and economic hardship. This study aims to examine education-based inequalities in the prevalence of VI among older adults (aged 45 years and above) in India.

Methods

The sample included Data from 59,555 older adults from the Longitudinal Ageing Study in India (LASI), 2017–18. We analyzed the prevalence of VI (distance and near vision impairment) among older adults. Using concentration curves we compared VI inequality along the axes of wealth and education. Erreygers Concentration Index (ECI) was used to measure education-based inequalities in the prevalence of VI, and a decomposition analysis was conducted to identify the socio-economic factors contributing to the inequalities.

Results

Overall, 79 % (95 % CI: 78.91, 79.76) of the older adults had VI based on 20/40 visual acuity. Our findings depict that there was significant education-based inequality in the prevalence of VI [ECI: -0.1792, (p<0.001)]. Education (55 %) was the primary contributing factor to inequality in the prevalence of VI. Additionally, gender (13 %) and residence (8 %) were prominent while wealth contributed only 3 %.

Conclusion

Study highlights a significant inequality in vision health in relation to educational attainments. Targeted Interventions that address educational disparities in health outcomes may help in reducing VI burden. A sustained policy focus on promoting healthy behaviors and routine eye check-ups, establishing dedicated geriatric eye clinics, and providing accessible and affordable healthcare services is desirable.