Visual impairment, discrimination, and emotional well-being in later life

Visual impairment affects an estimated 2 million people in the United Kingdom, with one in ten people over the age of 65 reporting some sight loss. This can have a profound impact on quality of life, not only because people with visual impairment commonly experience difficulties carrying out everyday activities, but also because they are more likely to encounter discrimination.

In a study published in JAMA Ophthalmology in May 2019, we used survey data collected from more than 7,000 older adults (50 years or older) in England to examine how prevalent perceived discrimination is among older people with visual impairment and to what extent it is associated with emotional well-being.

The surveys took place in 2010/11 and 2016/17. Respondents were classed as experiencing discrimination if they reported one of four experiences in the past year: being treated with less respect or courtesy, receiving poorer service than others at hotels or restaurants, people acting as if they think they are not clever, and being threatened or harassed. They were also counted as experiencing discrimination if they reported ever having received poorer treatment or service than other people from doctors or in hospitals.

We found that people who rated their eyesight as “poor”, even while wearing glasses or contact lenses, were 40% more likely to report being discriminated against than people who classed their vision as good.

In absolute terms, just over half of older adults with poor vision reported experiences of discrimination. These adults were twice as likely to report loneliness and depressive symptoms and were also much more likely to report a lower quality of life (measured by the CASP-19) and lower life satisfaction than peers with poor eyesight who did not experience discrimination.

Our results suggest that discrimination may be an important contributor to the lower levels of wellbeing among people with poor eyesight. In addition to addressing the injustice of unfair treatment, tackling the issue of discrimination against people with poor vision could also have substantial benefits for their mental health and wellbeing.

Guest blog by Dr Sarah Jackson, UCL Tobacco and Alcohol Research Group, University College London

Jackson SE, Hackett RA, Pardhan S, Smith L, Steptoe A. Association of Perceived Discrimination with Emotional Well-being in Older Adults with Visual Impairment. JAMA Ophthalmol. Published online May 30, 2019137(7):825–832. doi:10.1001/jamaophthalmol.2019.1230

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