Health
Today’s senior citizens are reporting fewer visual impairment problems than their counterparts from a generation ago, according to a new Northwestern Medicine study.
Improved techniques for cataract surgery and a reduction in the prevalence of macular degeneration may be the driving forces behind this change, the researchers said.
“From 1984 until 2010, the decrease in visual impairment in those 65 and older was highly statistically significant,” said Angelo P. Tanna, M.D., first author of the study. “There was little change in visual impairments in adults under the age of 65.”
The study, published in the journal Ophthalmology, shows that in 1984, 23 percent of elderly adults had difficulty reading or seeing newspaper print because of poor eyesight.
By 2010, there was an age-adjusted 58 percent decrease in this kind of visual impairment, with only 9.7 percent of elderly reporting the problem.
There was also a substantial decline in eyesight problems that limited elderly Americans from taking part in daily activities, such as bathing, dressing or getting around inside or outside of the home, according to the study.
“The findings are exciting, because they suggest that currently used diagnostic and screening tools and therapeutic interventions for various ophthalmic diseases are helping to prolong the vision of elderly Americans,” Tanna said.
Tanna is the vice chairman of ophthalmology at Northwestern University Feinberg School of Medicine and an attending physician at Northwestern Memorial Hospital. Stephen Kaye, of the Institute for Health & Aging and Disability Statistics Center, University of California, is the second author of the study.
The study used self-reported data collected from 1984 to 2010 through two major population-based surveys, the National Health Interview Survey and the Survey of Income and Program Participation.
Survey questions revealed how vision problems can impact the daily activities and quality of life of Americans and helped researchers analyze trends in the prevalence of visual impairment of adults in the United States.
While this study didn’t identify any of the causes of the change in the prevalence of visual impairment, Tanna said there are three likely reasons for the decline.
Those include improved techniques and outcomes for cataract surgery; less smoking, resulting in a drop in the prevalence of macular degeneration; and treatments for diabetic eye diseases are more readily available and improved, despite the fact that the prevalence of diabetes has increased.
Future studies should identify which treatment strategies help prevent vision in older adults and then make those treatments available to as many people as possible, Tanna said.
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Employment policy is also health policy according to a University of British Columbia study that found that workers experienced higher mortality rates if they didn’t have access to social protections like employment insurance and unemployment benefits.
Researchers with the Human Early Learning Partnership and the School of Population and Public Health at UBC found that low and medium-skilled workers in the United States are at a greater risk of death if they lose their job than their German counterparts, who have access to more robust employment protections and insurance.
“Employment insurance makes a difference to the health of the most vulnerable populations, low-wage and poorly educated workers,” said Chris McLeod, the lead researcher on the paper and a post-doctoral fellow with the Human Early Learning Partnership. “For low-wage and poorly educated workers, it’s not just about losing your job but losing your job and being at the bottom of the labor market.”
The study, published online earlier this month in the American Journal of Public Health, compared mortality rates of unemployed minimum, medium and high-skilled workers in Germany and the United States of America between 1984 and 2005.
While researchers found an increased risk of dying for all unemployed workers, the relative risk was higher for U.S. workers in almost all situations.
Unemployed minimum and medium skilled Americans were about seven and 3.5 times more likely to die than employed high skilled Americans or Germans.
The U.S. and Germany are the world’s two most successful economies but differ significantly in their employment policies.
Germany, a coordinated market economy, has high levels of both employment protection – restrictions on terminating employees – and unemployment protection – availability of unemployment benefits.
The United States, a liberal market economy, has low levels of employment and unemployment protection.
The study found that 75 per cent of unemployed German workers received unemployment compensation compared to only 19 per cent of U.S. workers.
Canada was not included in the study but has a liberal market economy similar to the U.S. The Canadian government is currently implementing reforms to the country’s employment insurance system, which may reduce benefits to low-income and low-skill workers.
“It is important that we recognize how changes to employment and unemployment protections could inadvertently affect the health of the most vulnerable populations,” said McLeod.
In a second study, published earlier this year in the Annual Review of Public Health, the researchers, along with Harvard University professor Peter Hall, looked at the policies that could help mediate health inequalities among workers.
The researchers found that broader employment and social policies that included training and education opportunities, employment security, access to housing and welfare, and benefits to low-income families were important social protections.
“The wear and tear of daily life is important to everyone’s health,” said Hall. “As these findings show, social policy matters not only to people’s well-being but to the very length of their lives.”
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