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How ‘Obamacare’ impacts eye health disparities


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Vision health disparities are a serious issue in the United States among minorities, and many are hoping provisions in the Affordable Care Act will be able to alleviate the issue.


Detroit—Disparities in vision and eye health-care opportunities among minorities is a big problem in the United States, according to M. Roy Wilson, MD, MS.

Furthermore, Dr. Wilson explained that these disparities have resulted in a high number of unnecessary vision loss among American minorities, as 6.9% of African Americans and 9.2% of Hispanics have impaired vision that could be easily remedied with eyeglasses.

‘There are a number of ophthalmic diseases for which there are disparities based on either race, ethnicity, or socially economic status,” said Dr. Wilson, president of Wayne State University, Detroit.

Though many physicians see the disparities problem as exclusively an access issue, Dr. Wilson said he believes there are more factors that play a role as well.

“There is lots of evidence that it’s not just access,” said Dr. Wilson, who is also the former deputy director for strategic scientific planning and program coordination at the National Institute on Minority and Health Disparities (NIMHD) of the National Institutes of Health (NIH). “The problem is much more widespread.”

That is where the Affordable Care Act (ACA) will come into play, Dr. Wilson said, as the health-care overhaul has the potential to reduce the dilemma greatly, while addressing its various causes.

ACA impact

There are four areas, Dr. Wilson explained, in which the ACA may have a significant impact on decreasing vision related disparities among minorities:

1. Infrastructure: The ACA has elevated the National Center for Minority Health and Health Disparities into the NIMHD. The act has given the newly formed agency overall responsibility for strategic planning and program coordination for all the health disparities related to research and training for the entire NIH.

The act also established the Office of Minority Health in the Health and Human Services Department, as well as in other government offices like the Centers for Disease Control and the Centers for Medicare and Medicaid.

2. Access: The health-care overhaul included many increased access provisions, including Medicaid expansion, insurance regulation/the American health benefit exchange, community health centers creation, as well as prevention and wellness additions.

These specific changes the ACA brings, Dr. Wilson said, could turn out to make a large impact on accessibility to health-care by minorities.

“Simply because more minorities (currently) have difficult with access,” he added.

3. Health-care workforce and cultural competency: There are a number of provisions associated with this area, as its intent is to improve the diversity of the workforce.

4. Quality improvement: The ACA will increase data collection and research to improve the quality of health-care for minorities.


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