According to the latest Census Bureau projections, minorities will account for 56% of the U.S. population by 2060. The largest growth is projected in the numbers of Hispanics, Asians, and persons of multiple races. Racial and ethnic disparities are prominent within eye-health. Black American and LatinX patients have significantly higher prevalence of diabetic retinopathy, glaucoma, cataract and overall visual impairment, whereas myopia is more common in Asian Americans.
Glaucoma occurs about five times more often in Black Americans and blindness from glaucoma is about six times more common. In addition to this higher frequency, glaucoma often occurs earlier in life in Black Americans — on average, about 10 years earlier than in other ethnic populations. Asian Americans are more likely to develop angle-closure glaucoma -- a rapid pressure increase in the eye -- than the general population.
Black Americans also have a 77% greater risk of developing diabetes than their White peers, and LatinX have a 66% higher risk. While there once was a perception that diabetic retinopathy was uncommon in youth, recent studies have indicated otherwise. One in five youth diagnosed with type 1 diabetes and 7% with type 2 diabetes will also have a diagnosis of diabetic retinopathy. Diabetic retinopathy is the 3rd leading source of overall blindness in the United States and the leading cause of new cases of legal blindness in working age Americans.
Yet, despite experiencing higher rates of vision loss, minority populations are less likely to undergo eye exams and vision screenings. In a recent study, for example, less than half of LatinX (49.0%) had an eye exam previously, compared to 60–68% of Black, Asian, and multiethnic counterparts even though LatinX had a higher incidence of visual impairment than that reported in non-Hispanic White persons and the highest reported in a population-based study in the US.
INVEST IN EARLY DETECTION & INTERVENTION
It is estimated that more than 20% of all school-age children in the United States have undiagnosed vision conditions which negatively impacts them academically.
Vision screenings are essential to the early identification and treatment of childhood ocular diseases such as strabismus (misaligned eyes) and amblyopia (lazy eye). Studies show that nearly 40% of pre-school aged children 3-to-5 years old miss out on vision screenings. Screening rates among children vary by race/ethnicity and family income, insurance as well as the educational attainment of the caregivers.
Coupled with full eye exams and free glasses, vision screenings have been credited with improving academic outcomes for some students with undiagnosed vision issues. According to a recent study released by Johns Hopkins University, reading scores increased significantly after one year of students who got glasses compared to students who got glasses later. For students performing in the lowest quartile and students participating in special education, wearing glasses equated to four to six months of additional learning—almost half a school year.
FFF has been investing in mobile eye-care delivery to increase accessibility, participation and literacy since our first grant making year in 2017.
With COVID thwarting school and community wide programs, in 2020 and 2021, FFF piloted a career development program that incorporated mentoring and job shadowing with mobile vision van screenings. High school students from four Big Picture Learning schools were given the opportunity to be mentored in job functions that interested them the most such as operations (logistics), finance (development), marketing (digital communications), and optometry (assisting).
Student narratives reinforced our TOT, with statements such as:
“I was not interested in eye care before I came, but this internship made me more interested because I now actually know what eye care is.” – Owen (Julia, Digital Communications)
I learned that it is super interesting to learn about our eyes, how we have to take care of them, and that it is very important to visit a specialist eye doctor. I am really very interested in medicine and taking care of your eyes is part of it.” -- Zulma Mendez (Uzi, Optician)
“Coming from a heavy Latino community, I understand the challenges of coming from a different country but still having the motivation to move forward. [One of my students only spoke Spanish and] I wanted to be as helpful as possible to her to help her learn a trade because I could tell she was genuinely interested in the internship. It motivated me to do it in her language [translate all my teaching materials]. I honestly kind of saw myself in those students. Not knowing what they want to do in life – that was me. I explained that a four-year college is not the only option; that there are other paths like a trade school, and it has been a blessing and opportunity for me and led to work in an organization like Vision To Learn.” – Uzi, Optician
During the pilot, students benefited from weekly sessions with their mentors with internships lasting from 6-weeks to three months. This included students setting up three separate eye care experience events where students and community members were screened, examined (if needed) and dispensed glasses (if needed). Though just 200 screenings were implemented, there was an extremely high fail rate of 47% which was surprising given that pre-COVID averages were around 28% in Los Angeles, according to our grantee, Vision To Learn.
