Epidemiology of Visual Impairment: The 1986-2002 NHIS

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DESCRIPTION (provided by applicant): Despite the importance of visual impairment (VI) as a public health problem there has been relatively little research on the influence of this condition on morbidity and mortality. The proposed investigative team was previously funded by the National Eye Institute to help, address this knowledge gap using data from the National Health Interview Survey (NHIS) 1986-1994. The NHIS was extensively improved and redesigned in 1997. The National Center for Health Statistics (NCHS) has released to the scientific community NHIS datasets thru 2002 which include information of the VI status of 195,907 adults; 2003 data have recently been released by NCHS adding approximately another 73,000 participants. Information on functional status, important risk factors such as smoking status, and access to care are additional features of the redesigned NHIS. In addition, the NCHS has instituted regular mortality linkage updates with the National Death Index for participants of the previous survey years (1986-1996) as well as for the redesigned NHIS (1997-2000) thru 2002; this new linkage is now available to investigators through the NCHS Research Data Center. The redesigned NHIS along with the updated mortality linkage for the previous NHIS will enable the present investigative team to expand the number of specific aims proposed in the current application to include structural equation modeling analysis as well as a website to provide NHIS ocular data and findings as a unique resource for interested investigators. Our study aims include: 1) Using structural equation modeling, determine the extent to which VI is related to mortality risk thru its "indirect" effect on morbidity and functional status among participants of the 1986-1996 and 1997-2000 NHIS's; 2) Estimate among adult participants of the 1986-1996 NHIS the overall and cause-specific mortality rates thru 2002 for adults with and without reported VI and selected eye diseases; 3) Estimate among participants of the 1997-2000 NHIS the short-term overall and cause-specific mortality rates thru 2002 for adults with and without reported VI additionally controlling for covariates not available in previous NHIS surveys such as smoking status; 4) Estimate the prevalence and severity of reported VI in sociodemographic subgroups using data from the redesigned NHIS survey (1997-2003); 5) Evaluate 7-year trends in VI in sub-groups (e.g., age-groups, gender, race, ethnicity) using data from the 1997-2003 NHIS's; 6) Evaluate the reported health and disability status of NHIS participants with and without reported VI; 7) Evaluate the association between VI and access to health care, including ophthalmic care; and 8) Produce and maintain a website directed at other scientists interested in using the ocular data available in the ongoing NHIS.