Black, Mexican-American Adolescents More Likely to Have Poor Visual Function

Adolescents who identified as Black, Mexican-American, or low-income and/or were not US citizens were more likely to report worse subjective visual function.

A cross-sectional study published in JAMA Ophthalmology found that persons who identified as Black or Mexican American, living in low-income households, and noncitizens of the United States were more likely to have poorer subjective visual function and had worse results on objective visual acuity tests. These findings could help provide insight into vision health inequities and find opportunities for interventions.

This study used data from the National Health and Nutrition Examination Survey from 2005 to 2008. Children aged 12 to 18 years with completed vision questionnaires and examinations were included. All children were asked the perceived quality of their vision. Visual acuity was also measured using a built-in acuity chart. Those with 20/40 vision in the better seeing eye were classified as having poor vision. Sociodemographic factors of the participants were also examined, including age, sex, race and ethnicity, family income, household size, and US citizenship. All participants were categorized as non-Hispanic Black, Mexican American, non-Hispanic White, and other.

There were 2833 participants in this study, with a mean (SD) age of 15.5 (2.0) years; 51% of the participants were men. Of the participants, 876 were non-Hispanic Black, 828 were Mexican American, 816 were non-Hispanic White, and 313 were "other" race participants included in this study. There were 266 participants who were not US citizens and 773 with a family income below poverty level.

Prevalence of poor subjective visual function was higher in participants who identified as Black (11.8% vs 3.8%; 95% CI, 6.1%-10.0%). Poor subjective visual function was also more prevalent in non-US citizens vs US citizens (13.1% vs 6.0%; 95% CI, 0.9%-13.2%), low-income families compared with higher-income families (13.8% vs 4.6%; 95% CI, 6.0%-12.4%), and large households vs small households (8.8% vs 6.0%; 95% CI, 0.2%-5.4%)

Participants with 20/40 vision were more often Black (15.6% vs 7.2%; 95% CI, 4.4%-12.4%) and Mexican American (17.9% vs 7.2%; 95% CI, 7.2%-14.1%). It was also more prevalent in noncitizens of the United States compared with US citizens (21.3% vs 9.7%; 95% CI, 4.3%-18.8%) and participants from large vs small households (13.9% vs 9.6%; 95% CI, 0.5%-8.3%).

There were increased odds of poor subjective vision in Black participants (odds ratio [OR], 2.85; 95% CI, 2.00-4.05), Mexican-American individuals (OR, 2.83; 95% CI, 1.70-4.73), and low-income participants (OR, 2.44; 95% CI, 1.63-3.65) when adjusting for age, sex, and other covariates in a multivariable regression analysis.

There were also increased odds of low presenting visual acuity for Black (OR, 2.13; 95% CI, 1.41-3.24), Mexican-American (OR, 2.13; 95% CI, 1.39-3.26), and non-US citizen (OR, 1.96; 95% CI, 1.10-3.49) participants.

There was 1 limitation to this study. The data for this study were from 2005 to 2008, which means that the findings may not reflect the current population of US adolescents.

The researchers concluded that adolescent children who identify as Black, Mexican American, being from a low-income household, or non-US citizens were more likely to have poor subjective visual function and objective visual acuity.

“Improving access to vision care services may decrease the burden of preventable visual impairment extending into adulthood,” the authors wrote.


Adomfeh J, Jastrzembski BG, Oke I. Association of race, ethnicity, and socioeconomic status with visual impairment in adolescent children in the US. JAMA Ophthalmol. Published online September 15, 2022. doi:10.1001/jamaophthalmol.2022.3627