Why are there gender inequalities in visual impairment?

• Published in: European journal of public health Vol. 29; no. 4; pp. 661 - 666
• Main Authors: Rius Ulldemolins, Anna, Benach, Joan, Guisasola, Laura, Artazcoz, Lucía
• Format: Journal Article Publication
• Language: English
• Published: England Oxford University Press 01-08-2019; Oxford Publishing Limited (England)
• Subjects: Age; Aspectes socials; Autonomy; Blindness; Cataracts; Ceguesa; Ciències de la visió; Desigualtats econòmiques regionals; Disease; Educational attainment; Educational inequality; Epidemiologia; Epidemiology; Eye; Eye diseases; Gender; Gender aspects; Gender differences; Gender inequality; Glaucoma; Health care; Health care access; Health services; Impairment; Income inequality; Men; Physical disabilities; Public health; Regional economic disparities; Regression analysis; Regression models; Sex differences; Sexism; Sexisme; Socialization; Trastorns de la visió; Vision disorders; Visual impairment; Visual observation; Women; Womens health; Àrees temàtiques de la UPC
• ISSN: 1101-1262; 1464-360X; 1464-360X
• DOI: 10.1093/eurpub/cky245

Abstract
Background
In high-income countries, the prevalence of blindness and visual impairment is higher among women, regardless of age although the mechanisms that produce these gender inequalities are not well understood. The objectives of this study were to analyse gender inequalities in the prevalence of blindness and visual impairment, age of onset, diagnosed and undiagnosed status and related eye diseases among visually impaired individuals.
Methods
Data were obtained from the 2008 Spanish Survey on ‘Disability, Personal Autonomy and Dependency Situations’ (n = 213 626) participants 360 blind (160 men and 200 women), and 5560 with some visual impairment (2025 men and 3535 women). The prevalence of blindness and visual impairment, age of onset of visual impairment and diagnosed and undiagnosed eye diseases was calculated. Hierarchical multiple logistic regression models were fit to test gender differences.
Results
Women were more likely to report visual impairment (crude OR = 1.6 [95% CI: 1.56–1.74]). Prevalence of diagnosed cataract was higher among visually impaired women (crude OR = 1.4 [95% CI: 1.25–1.67]) whereas undiagnosed eye disease (crude OR = 0.7 [95% CI: 0.64–0.81]) or diagnosed glaucoma (aORsex = 0.8 [95% CI: 0.65–0.93]) were more frequent among visually impairment men. These associations were not explained by age or educational level.
Conclusions
Strong gender inequalities were observed, with a higher prevalence of visual impairment and related cataracts among women, which could be related to gender inequalities in access to health care, and undiagnosed eye disease and related glaucoma among men, which could be related to their gender socialization resulting in less frequent and effectively use of health care services.