Association Between Sociodemographic Factors and Self-Reported Diabetic Retinopathy: A Cross-sectional, Population-Based Analysis.

Purpose: This study aimed to investigate the relationship between sociodemographic and healthcare access factors with self-reported diabetic retinopathy (DR) prevalence in a nationally representative sample of the United States.

Design: This is a population based, cross-sectional analysis METHODS: Data from those who answered the question, "Have you ever been told by a doctor or other health professional that you had diabetic retinopathy?" from the 2017 National Health Interview Survey (NHIS) was analyzed through logistic regression to examine the association between DR prevalence and social determinants of health (SDH).

Results: Of 26,966 eligible NHIS respondents (81.4%), 26,699 participants answered the DR question, of whom 266 (1.0%) self-reported a DR diagnosis. Multivariable analysis found a significant association between DR prevalence and the following social determinants of health:, poorer health status (OR=5.9; 95%CI=3.6-9.7; p<0.001), disability (OR 2.1; 95%CI 1.3 - 3.2; p=0.001), no employment status (OR= 1.8; 95%CI= 1.2 - 2.9; p=0.009), and living in Southern regions of the US (OR= 1.9; 95%CI= 1.1 - 3.3; p=0.020). Not having a usual place for healthcare (OR 0.3; 95% CI 0.1 - 0.7; p=0.006) and female sex (OR= 0.6; 95%CI= 0.4 - 0.8; p=0.002) were negatively associated with self-reported DR prevalence.

Conclusion: Multiple sociodemographic factors are associated with self-reported DR prevalence. Health care providers and policymakers should tailor future interventions to address SDH in a holistic model of DR screening and care.