Date Presented 04/04/19
This study aimed to use a novel data-collection method to characterize the existing low-vision service delivery system and calculate the prevalence rate of VI within Massachusetts. Existing services were identified and mapped. Synthetic estimation was used to make estimates of the prevalence of VI of the 351 towns in Massachusetts, using national estimates of VI and town-level census data. Data were then used to identify gaps and prioritize need and could be applied to other states with other populations.
Primary Author and Speaker: Jennifer Kaldenberg
PURPOSE: This study aimed to characterize the existing low vision service delivery system and calculate the prevalence rate of visual impairment (VI) by town throughout MA and presents a methodology that could be applied to others states to identify gaps within the system and prioritize need.
METHOD: Quantitative methods were used to calculate the prevalence of VI and number of individuals registered as legally blind by town, and to identify the existing services within MA. Existing services provided throughout MA were identified through literature review and ongoing communication with low vision stakeholders. Services were categorized as low vision services, community and social services, and peer support groups. Synthetic estimation was used to make estimates of the prevalence of VI of the 351 towns in MA, using national estimates of VI and town level census data (United States Census Bureau, 2018; NEI, 2016). These data were used to identify high and low resourced communities and provide quantitative data to inform service delivery.
RESULTS: Geographic Information Systems (GIS) maps were created to visualize the prevalence rate of VI or the number of individuals registered with as legally blind and the services available by town. The analysis shows the prevalence rate of VI and the distribution of services throughout the state. The maps also clearly illustrate the gaps in services available within towns throughout MA. Ninety one percent of all towns were identified as low resourced. Overall, communities with aging populations have the highest prevalence of VI and are found in suburban or rural areas. Conversely, the greatest number of resources were found in larger urban communities. This is consistent with previous findings, which found rural communities had increased barriers to basic and specialty eye care services (MacLennan et al., 2014; Overbury & Wittich, 2011). However, it is important to note that service reach was not evaluated within this study. It is possible that some services provided outreach to more rural communities.
CONCLUSION: As the majority of visual impairments are progressive and chronic, the data provided in this study can inform resource allocation and program development in order to address the ongoing needs of individuals with VI. Areas for continued research and evaluation include analysis of the services provided within the communities, their effectiveness, sustainability, and reach. Access to services in identified high resourced communities was not taken into consideration for this study. Future research could explore transportation and other barriers which may influence LVRS use. With the aging of the population, both prevalence rates and available services will be important factors to consider when identifying future health care resources. The results of this study can be used to inform the development of a new model of service delivery.
IMPACT STATEMENT: The GIS maps can be used to prioritize efforts for new service provision, outreach to underserved populations, and education campaigns to improve awareness of LVRS throughout the state. Key findings indicate high and low resourced communities and the need to prioritize service provision in low resources communities throughout Massachusetts.
References
United States Census Bureau. (2018). American Fact Finder. Retrieved from: https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml
National Eye Institute. (2016). Prevalence of adult vision impairment and age-related eye diseases in America. Bethesda, MD: National Eye Institute. Available from: https://nei.nih.gov/eyedata/adultvision_usa
MacLennan, P. A., McGwuin Jr., G., Searcey, K., & Owsley, C. (2014). A survey of Alabama eye care providers in 2010-2011. BMC Ophthalmology, 14(44), 1-10. doi: 10.1186/1471-2415-14-44.
Overbury, O., & Wittich, W. (2011). Barriers to low vision rehabilitation: Montreal barriers study. Investigative Ophthalmology and Visual Science, 52(12). 8933-8938. doi: 10.1167/iovs.11-8116
