Health Disparities in Visually Impaired Adults with Multimorbidity

患有多种疾病的视障成人的健康差异

• 批准号: 9117135
• 负责人: Dandan Diane Zheng
• 金额: $ 4.36万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9117135
• 关键词: Address; Adult; Affect; Aging; Arthritis; Automobile Driving; Centers for Disease Control and Prevention (U.S.); Chronic; Chronic Disease; Communities; Comorbidity; Complex; Data; Diabetes Mellitus; Disadvantaged; Disease; Elderly; Epidemiology; Equation; Ethnic Origin; Evaluation; Expenditure; Eye diseases; Face; General Population; Goals; Health; Health Care Costs; Health Status; Health behavior; Hearing; Hip region structure; Hypertension; Individual; Injury; Intervention; Labor Forces; Life; Life Expectancy; Link; Longevity; Measures; Medical; Mental Health; Methodology; Minority; Modeling; Morbidity - disease rate; National Eye Institute; National Health Interview Survey; Occupations; Outcome; Outcome Study; Patients; Pattern; Persons; Policy Maker; Population; Prevalence; Productivity; Quality of life; Quality-Adjusted Life Years; Race; Reporting; Research; Research Infrastructure; Resources; Risk; Sampling; Social Functioning; Socioeconomic Status; Statistical Models; Strategic Planning; Stroke; Subgroup; Surveys; Techniques; Typology; Vision; Vision Disorders; Visual; Visual impairment; Vulnerable Populations; Weight; burden of illness; disability; effective intervention; health disparity; high risk; improved; indexing; interest; low socioeconomic status; mortality; multiple chronic conditions; novel; physical conditioning; population based; population health; preference; public health relevance; respiratory; social

 DESCRIPTION (provided by applicant): Visual impairment (VI) is associated with lower productivity, poorer quality of life, and greater mortality. People with VI cannot perform certain types of jobs, are subject to driving restrictions, and are at an increased risk for injuries. Such limitations can directly affect both physical and mental health status, reduce social functioning, and reduce participation in the labor force. It is well known that VI is among the most disabling chronic conditions which older adults often face. Less is known about possible synergistic impacts on morbidity and mortality when persons must live with VI in addition to other chronic disabling conditions and how these impacts may differentially affect important subgroups of interest such as minority populations. To better understand how health disparities synergize with social disadvantages among the visually impaired with and without other chronic health conditions, this study will utilize data from the National Health Interview Survey (NHIS) and the Medical Expenditure Panel Survey (MEPS) to identify visually impaired subpopulations who are also living with various co-morbid conditions and who may suffer disproportionally (relative to the general population) in terms of morbidity and mortality. Once identified, the most toxic combinations of VI and co- morbidities in terms of mortality risk will be categorized and ranked using advanced statistical modeling techniques available. This study will then use these newly characterized "high mortality risk" subpopulations to guide our analyses of differences in quality adjusted life years(QALYS), a measure which combines the morbidity and mortality of disease into a single metric expressing the number of years of optimal health an individual has remaining (i.e. health adjusted life expectancy). The proposed research will increase the understanding of the detrimental impact that visual impairment has on health and longevity which may have underestimated. In addition, results from this research will provide clinicians and policy makers with novel information regarding complex disease patterns (VI plus co-occurring conditions), which can then be used to identify and intervene in extremely high risk populations. These study aims support key goals of the National Eye Institute (NEI) ocular epidemiology strategic planning report, which include: (1) Determine the burden of eye diseases and their visual outcomes in a changing population, and; (2) Develop new methodologies to support ophthalmic epidemiological research.14 The proposed research also supports the CDC and NEI initiatives for improving vision--related population health, including the identification o comorbidities associated with VI that increase disability.

 描述（由申请人提供）：视力障碍 (VI) 与生产力较低、生活质量较差和死亡率较高有关。患有 VI 的人无法从事某些类型的工作，受到驾驶限制，并且受伤的风险增加。这样的 限制会直接影响身心健康状况、降低社会功能并减少劳动力参与。众所周知，VI 是老年人经常面临的最致残的慢性疾病之一。当人们除了患有其他慢性致残疾病外还必须患有 VI 时，对发病率和死亡率可能产生的协同影响以及这些影响如何对少数民族人口等重要的亚群体产生不同的影响，人们知之甚少。为了更好地了解患有或不患有其他慢性健康问题的视障人士的健康差异如何与社会劣势协同作用，本研究将利用国家健康访谈调查 (NHIS) 和医疗支出小组调查 (MEPS) 的数据来识别视障亚人群，他们也患有各种共病，并且在发病率和死亡率方面可能遭受不成比例的影响（相对于一般人群）。一旦确定，将使用现有的先进统计建模技术对死亡风险方面最具毒性的 VI 和合并症组合进行分类和排名。然后，本研究将使用这些新特征的“高死亡风险”亚群来指导我们对质量调整生命年（QALYS）差异的分析，该指标将疾病的发病率和死亡率结合成一个单一指标，表示个体剩余的最佳健康年数（即健康调整预期寿命）。拟议的研究将增加人们对视力障碍对健康和寿命可能被低估的有害影响的了解。此外，这项研究的结果将为临床医生和政策制定者提供有关复杂疾病模式（VI加并发病症）的新信息，然后可用于识别和干预极高风险人群。这些研究目的支持国家眼科研究所 (NEI) 眼部流行病学战略规划报告的主要目标，其中包括：(1) 确定不断变化的人群中眼部疾病的负担及其视力结果； (2) 开发新的方法来支持眼科流行病学研究。14 拟议的研究还支持 CDC 和 NEI 改善视力相关人群健康的举措，包括识别与 VI 相关的导致残疾增加的合并症。