1、Moderator:Jim McGannBoard ChairPrevent Blindness Dean A.VanNasdale,OD,PhD,FAAOAssociate ProfessorThe Ohio State University College of OptometrySESSION 5:2023 Jenny Pomeroy Award for Excellence in Vision and Public HealthFocus on Eye Health Summit PresentationUsing Population Health Data to Promote E

2、ye HealthDean A.VanNasdale,OD,PhD,FAAODean A.VanNasdale,OD,PhD,FAAOAssociate ProfessorOhio State University College of Optometryvannasdale.1osu.edu A Team Approach to Addressing Vision Health Ohio State University Erica Shelton,OD,MS,FAAO Megan Hurley,OD,MS Lisa Jones-Jordan,PhD,FAAO Matt Robich,MPH

3、 Andrew Wapner,DO,MPH Keith Ramsey Kerri McTigue Karla Zadnik,OD,PhD,FAAO John Crews DPA Prevent Blindness Ohio Sherry Williams David Monder Ohio Department of Aging Marc Molea(retired)Indiana University Chris Clark,OD,PhD,FAAO National Association of Chronic Disease Directors Carol McPhillips Tangu

4、m Centers for Disease Control and Prevention Jinan Saaddine,MD,MPHOutline BackgroundWhere the Data ResideWhat the Data Are Telling UsIdentifying Upstream InfluencesFuture WorkOutline BackgroundWhere the Data ResideWhat the Data Are Telling UsIdentifying Upstream InfluencesFuture WorkJohn E Crews,DPA

5、My First Clinical Experiences With Public Health and Vision https:/ Swan,OD,MEd,FAAOVision Healths Representation in Public Health Priorities Healthy People 2030 Healthy People provides science-based,10-year national objectives for improving the health of all Americans Vision Workgroup Objectives Re

6、duce vision loss from diabetic retinopathy in adults age 18 years and over with diabetes(V-04)Baseline:33.0 per 1,000 Target:16.5 per 1,000Our Current TrajectoryOur Path to Achieve Our Vision Objectives is Not Entirely Clear“Sound decisions about public policy and the prioritization of resources dep

7、end on having relevant and timely surveillance data.Surveillance of vision impairment and eye health is limited,however,and the lack of adequate surveillance has a substantial impact on public health efforts to address vision problems.”-National Academies of Sciences,Engineering and MedicineOutline

8、BackgroundWhere the Data ResideWhat the Data Are Telling UsIdentifying Upstream InfluencesFuture WorkThe Public Health FrameworkThe three core functions and ten essential public health servicesAnn Elsner,PhDYou need to consider the tools you have and decide which of them can most effectively solve y

9、our problem.Monitoring Health Sources of population-based vision impairment data American Community Survey(ACS)Administered by the U.S.Census Responses by mail,in person interview,internet,or telephone Behavioral Risk Factor Surveillance System(BRFSS)Administered by the U.S.Centers for Disease Contr

10、ol and Prevention Telephone survey“Are you blind or do you have serious difficulty seeing,even when wearing glasses?”Case definition frequently used to measure vision impairment in vision research(Crews,2012)Components of the BRFSS Core Module Standard set of questions asked to all respondents witho

11、ut modification Optional Modules Standardized set of questions that states can elect to include State-added Questions Questions that can be introduced by a state to address unique issuesMonitoring Health The Public Health FrameworkThe three core functions and ten essential public health servicesOutl

12、ine BackgroundWhere the Data ResideWhat the Data Are Telling UsIdentifying Upstream InfluencesFuture WorkChronic Conditions and ComorbiditiesVision Impairment and Physical Health“Now thinking about your physical health,which includes physical illness and injury,for how many days during the past 30 d

13、ays was your physical health not good”Non-visually impaired number of physically unhealthy days 2.89(North Dakota and Nebraska)4.97(West Virginia)Visually impaired number of physically unhealthy days 8.34 days(Utah)13.41 days(Tennessee)Vision Impairment and Physical Health We can quantify how indivi

14、duals with visual impairment have poorer physical health than those who are not visually impaired.The next logical questions are What are some of the conditions that are contributing to poor physical health in the visually impaired population?What is the magnitude of the problem?These conditions are

15、 not mutually exclusive.What the Data Are Telling Us With Severe Vision ImpairmentWithout Severe VisionImpairmentWhat the Data Are Telling Us With Severe Vision ImpairmentWithout Severe Vision ImpairmentWhy Do These Combinations Matter?Crews JE;Chou CF,Stevens JA,Saaddine JB.Falls Among Persons Aged

16、 65 Years With and Without Severe Vision Impairment United States,2014.MMWR Morb Mortal Wkly Rep.2016 May 6;65(17):433-7.What the Data Are Telling UsThe Public Health FrameworkThe three core functions and ten essential public health servicesCombining Data to Promote Population HealthStephen Burns,Ph

17、DInteresting picture.Now you have to figure out what it means and whether we can do anything about it.Outline BackgroundWhere the Data ResideWhat the Data Are Telling UsIdentifying Upstream InfluencesFuture WorkThe Multidimensional Complexity of the ChallengeNational Academies of Sciences,Engineerin

18、g,and Medicine.2016.Making eye health a population health imperative:Vision for tomorrow.Washington,DC:The National Academies Press.Social Determinants of Health(SDoH)The conditions in the environments where people are born,live,learn,work,play,worship,and age that affect a wide range of health,func

19、tioning,and quality-of-life outcomes and risks.SDOH can be grouped into 5 domains.Evaluating Health Care Access and UtilizationVision Impairment PrevalenceAmerican Community SurveyLack of Vision Care AccessOhio Medicaid Assessment Survey“During the past 12 months,was there a time when you needed vis

20、ion care or eye glasses,but could not get it at that time?”The Public Health FrameworkThe three core functions and ten essential public health servicesUsing Existing Infrastructure to Evaluate Vision Care Access and Utilization Using the BRFSS for state-specific policy assessments Vision Module and

21、state-added questions Assessing vision care utilization and the impact of Medicaid expansion in Ohio The primary reason individuals dont seek vision care services is that they do not perceive a need Insurance coverage for vision care services has increased in between 2005-2011 and 2018-2019 Despite

22、increases in vision care coverage,utilization of vision care services has remained stagnant The Public Health FrameworkThe three core functions and ten essential public health servicesMobilizing Partnerships to Improve Care CoordinationHealthy People 2030V-08 Increase the use of vision rehab service

23、s by people with vision lossBaseline:4.3%Target:6.2%V-09 Increase the use of assistive and adaptive devices by people with vision lossBaseline:12.4%Target:15.9%Outline BackgroundWhere the Data ResideWhat the Data Are Telling UsIdentifying Upstream InfluencesFuture WorkVision Impairment and Mental He

24、alth“Now thinking about your mental health,which includes stress,depression,and problems with emotions,how many days during the past 30 days was your mental health not good?”Non-visually impaired number of mentally unhealthy days(out of 30)No VI and no depression:2.49 days No VI and depression:11.29

25、 daysVisually impaired number of mentally unhealthy days(out of 30)VI and no depression:4.35 days VI and depression:15.62 daysVision Impairment and Mathematical ModelingChristopher Clark,OD,PhDIndiana University School of Optometry45Photo:Kay Hinton,Emory University“The reason for collecting,analyzi

26、ng,and disseminating information on a disease is to control that disease.Collection and analysis should not be allowed to consume resources if action does not follow.”William Foege,1976Former CDC DirectorSignificant role in smallpox eradicationThere is Still a Lot of Work to DoResources and Useful L

27、inks The Vision Health Initiative https:/www.cdc.gov/visionhealth/index.htm CDCs Vision and Eye Health Toolkit https:/www.cdc.gov/visionhealth/pdf/VisionAndEyeHealthGuide508.pdf State Profiles in Vision Health https:/www.cdc.gov/visionhealth/data/state-profiles/index.htm Vision Impairment and Physical Healthy Days https:/www.ncbi.nlm.nih.gov/pmc/articles/PMC8505137/Vision Care Utilization and Insurance Coverage Assessment in Ohio https:/ YouQuestions?vannasdale.1osu.edu