‘Culture in the clinic’: A Review of the Public Health Challenge of Preventing Age-Related Low Vision or Blindness in African Americans: With Implications for Eye Health Care in Australia

Julie Fitzpatrick, BOrth BSc PGDipHlthResMeth PGDipHlthProm

There is a body of evidence indicating African Americans are at a higher risk of developing blindness or low vision from ageing-related eye conditions, largely due to lack of attendance at eye screenings or non-compliance with treatment. Three eye conditions which will be discussed in this context are cataract, glaucoma and diabetic retinopathy. The aim of this literature review is to demonstrate that, when planning programs such as eye screenings, it is important to consider the cultural needs of the client group under study. This paper attempts to demonstrate how addressing cultural needs and culturally-determined barriers to eye screening attendance could greatly enhance program success. Australia’s cultural mix indicates there is a need to consider all races when planning programs. Using this holistic approach in a similar manner but applied to more local populations, such as indigenous Australians could also enhance eye screening attendance rates for these subjects.

The literature suggests the health issue of low vision or blindness in African Americans is largely attributable to geographic and culturally-determined behavioural factors posing a barrier to seeking professional eye screening and treatment. Also, culturally determined barriers to modifying diet and lifestyle habits influence control of sight-threatening diabetes resulting in poorer vision, which generally deteriorates with age.

It has been reported that African Americans would benefit from public health intervention to help prevent or minimise low vision. If this health issue is successfully addressed, there could be significant reductions in the economic health care burden in regions where this population resides, and patients could enjoy a better quality of life.