Socio-economic status, visual impairment and the mediating role of lifestyles in developed rural areas of China

PURPOSE: To examine the impacts of socio-economic status (SES) on visual impairment (VI), and the mediating role of lifestyles in developed rural areas of China. METHODS: A cross-sectional study was conducted among people living in rural districts of Tianjin, a developed municipality in China. An interviewer-administered survey along with free eye screenings was conducted with participants. The questionnaire included questions about demographic characteristics, SES, medical histories and lifestyles. Presenting visual acuity (PVA) and main causes of VI were identified by ophthalmologists. χ2 test was undertaken to determine whether significant differences (p<0.05) exist between VI and demographic, SES, medical history and lifestyle factors. A stepwise regression method was conducted to investigate whether lifestyles play mediating roles between SES and VI. Multivariable logistic and ordinal logistic regression were used contingent on different types of dependent variables in each regression, and adjusted odds ratio (OR) values were estimated. RESULTS: Of the 12,233 participants, 6,233 were male (50.59%); the mean age was 34.61 years; 310 (2.54%) had VI. Hypertension, diabetes and cardiopathy were main medical histories, with 1,640 had hypertension (13.41%), 854 had diabetes (6.98%) and 483 had cardiopathy (3.95%). About SES factors, higher education level (Adjusted OR, 0.84; 95% CI, 0.75–0.95) and higher income level (Adjusted OR, 0.54; 95% CI, 0.39–0.76), were significantly associated with VI in a gradient across severity of VI. Lifestyles including smoking (Adjusted OR, 1.55; 95% CI, 1.31–1.83) and drinking (Adjusted OR, 1.36; 95% CI, 1.06–1.74) played mediating roles between SES and VI when considering the full sample. Besides smoking and drinking, reading every week (Adjusted OR, 2.07; 95% CI, 1.53–2.82) and exercising more than 2h every day (Adjusted OR, 0.39; 95% CI, 0.15–1.00) also played mediating roles between SES and VI when considering the subsample (age≥16). CONCLUSION: This study revealed the crucial impacts of SES factors on VI, and the mediating role played by several lifestyles. Targeted public health interventions for reducing VI should thus be proposed in developed rural areas of China.