Racial, ethnic disparities endanger eye health of diabetes patients—Tulane study

April 29, 2014

Arthur Nead
Phone: 504-247-1443


Lizheng Shi, Regents Associate Professor of Global Health Systems and Development. Photo by Paula Burch-Celetano

Minority adults with diabetes are significantly less likely to receive eye examinations than whites with diabetes, says a study by researchers at Tulane University School of Public Health and Tropical Medicine. This disparity in access to eye care means that members of minorities are less likely to receive timely treatment for diabetic retinopathy, a major cause of blindness among American adults.

Retinopathy, characterized by leaking or abnormal blood vessels in the retina, is the most common eye disease linked to diabetes. Unchecked, it can lead to partial vision loss or total blindness. 

The research team looked at data gathered nationally from 276,774 adults during 2002-2009. Out of the total, 14,018 diabetes patients completed a diabetes-specific questionnaire asking if the respondent had undergone a dilated eye exam during that current year. Race and ethnicity were self-reported and used to define a respondent as either a non-Hispanic white or minority individual.

The study revealed that health insurance coverage was the consistent and most significant factor in determining disparities in eye examination rates.

“Expansion of health insurance coverage under the Affordable Care Act (Obamacare) may likely improve the access to preventive services for diabetes care,” says study leader Lizheng Shi, Regents Associate Professor in the Department of Global Health Systems and Development.

However, the project team including Dr. Yingnan Zhao, assistant professor, College of Pharmacy, Xavier University of Louisiana, found that minorities still have worse performances on eye examinations than non-Hispanic whites within those who are insured.

“This interesting finding suggests that simply giving an insurance card to a minority patient with diabetes may not fully address the racial/ethnic disparity in diabetes preventive care,” says Shi. “Many issues such as patient attitude and health literacy as well as availability of health providers have to be addressed to further achieve equitable and effective diabetes care.”

Tulane University, New Orleans, LA 70118 504-865-5000