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Brief Report |

Association of Vision Loss and Work Status in the United States

Cheryl E. Sherrod, MD, MPH1,2; Susan Vitale, PhD, MHS3; Kevin D. Frick, PhD4; Pradeep Y. Ramulu, MD, MHS, PhD1
[+] Author Affiliations
1Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland
2Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
3Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, Maryland
4Carey Business School, Johns Hopkins University, Baltimore, Maryland
JAMA Ophthalmol. 2014;132(10):1239-1242. doi:10.1001/jamaophthalmol.2014.2213.
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Importance  Working is critical to personal health and well-being. We examine the association of vision measured objectively with work status using a nationally representative sample of working-age Americans.

Observation  A total of 19 849 participants from the 1999-2008 National Health and Nutrition Examination Survey completed a vision examination and employment/demographic questionnaires. Employment rates for men with visual impairment, uncorrected refractive error, and normal vision were 58.7%, 66.5%, and 76.2%, respectively; employment rates for women with visual impairment, uncorrected refractive error, and normal vision were 24.5%, 56.0%, and 62.9%, respectively. In multivariable models adjusting for age, sex, race/ethnicity, and chronic disease status, both uncorrected refractive error (odds ratio [OR], 1.36; 95% CI, 1.15-1.60) and visual impairment (OR, 3.04; 95% CI, 1.93-4.79) were associated with a higher likelihood of not working. Subgroups in which visual impairment was associated with even higher odds of not working included women (OR, 4.9; 95% CI, 2.5-9.6), participants younger than 55 years (OR, 4.3; 95% CI, 2.9-6.5), and diabetic individuals (OR, 14.8; 95% CI, 5.8-37.3).

Conclusions and Relevance  Decreased vision is associated with a significantly higher likelihood of not working. Visually impaired diabetic individuals, women, and those younger than 55 years have a particularly high risk of not working. Further investigation is warranted to understand barriers for employment in individuals with decreased vision.

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Figure.
Employment by Vision Status and Visual Impairment Categorized by Sex, Age, and Diabetes Mellitus Status: NHANES 1999-2008

NHANES indicates the National Health and Nutrition Examination Survey; URE, uncorrected refractive error; and VI, visual impairment.

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