Prevalence of vision and hearing impairment in Australia: a nationally representative survey of Indigenous and non-Indigenous Australians aged 50 years and older.
The study found that vision impairment is significantly more prevalent among Indigenous Australians compared to non-Indigenous Australians, highlighting a critical health disparity.
Where it sits
this study against the rest of the semax corpusSummary and findings
The study aimed to estimate the prevalence and risk factors of vision and hearing impairment among Indigenous and non-Indigenous Australians aged 50 years and older. A total of 4519 participants were recruited, with 617 being Indigenous. The age-standardised prevalence of any vision impairment was 11.1% among Indigenous participants and 3.9% among non-Indigenous participants.
Abstract
<h4>Background</h4>Vision and hearing impairment are leading causes of disability, yet nationally representative data in Australia, particularly among Indigenous peoples, are scarce. The Australian Eye and Ear Health Survey aimed to estimate prevalence and risk factors of vision impairment and hearing impairment among Indigenous and non-Indigenous adults aged 50 years and older nationwide.<h4>Methods</h4>This cross-sectional survey used stratified, multistage, random cluster sampling and was conducted across 30 sites in Australia. Stratification was done by geographical location and by Indigenous status to achieve national representativeness. Participants were systematically assessed for any vision impairment (presenting visual acuity <6/12 in the better eye), and any hearing impairment, and moderate or worse hearing impairment (pure tone average>25 decibels hearing level [dB HL], and >40 dB HL in the better ear), respectively. Door-to-door recruitment was the primary recruitment method. Crude and age-standardised prevalence estimates were calculated. Multivariable logistic regression models identified risk and protective factors.<h4>Findings</h4>Between Aug 1, 2022, and March 31, 2025, a total of 4519 of 6128 eligible participants were recruited, of whom 617 (13·6%) participants were Indigenous (53·2% [328 participants] female vs 46·8% [289 participants] male; mean age 63·8 [SD 10·6] years) and 3902 (86·4%) participants were non-Indigenous (54·8% [2137 participants] female vs 45·2% [1765 participants] male; mean age 70·5 [9·8] years). The age-standardised prevalence of any vision impairment was 11·1% (95% CI 8·4-14·5) among Indigenous participants, 3·9% (3·3-4·6) among non-Indigenous participants, and 5·2% (4·5-6·0) overall. Any vision impairment was 2·9-times more prevalent among Indigenous than non-Indigenous Australians. The age-standardised prevalences of any hearing impairment, and moderate or worse hearing impairment were 42·8% (95% CI 36·8-49·5) and 14·3% (11·0-18·4) in Indigenous participants; 39·4% (37·3-41·8) and 13·2% (12·0-14·5) in non-Indigenous participants, and 41·7% (39·6-43·9) and 14·2% (13·1-15·5) overall, respectively. Among younger Indigenous participants, moderate or worse hearing impairment was almost three-fold higher than in similarly aged non-Indigenous participants (9·4% [95% CI 5·3-15·8] vs 3·2% [1·8-5·5] among individuals aged 50-59 years), and two-fold higher for Indigenous participants aged 60-69 years (14·3% [9·7-20·4] vs 6·9% [5·4-8·8]). Multivariable-adjusted risk factors in the whole sample were increasing age (both vision impairment and hearing impairment), having diabetes (both), current smoking (hearing impairment), and residence in remote locations (vision impairment). Protective factors were attainment of tertiary education (both), having private health insurance (both), attending an eye examination in the last 12 months (vision impairment), and female sex (hearing impairment). Indigenous status was associated with approximately two to three-fold greater risk of any vision impairment or hearing impairment in age-sex adjusted models, but this effect was no longer statistically significant after adjustment for other covariables.<h4>Interpretation</h4>A substantial gap in vision impairment and, to a lesser extent, hearing impairment, persists between Indigenous and non-Indigenous Australians aged 50 years and older. Targeting shared modifiable risk factors and protective factors could reduce this inequity.<h4>Funding</h4>Australian Government and Macquarie University.
Background
This study addresses the prevalence of vision and hearing impairment, significant contributors to disability among older adults. Prior research indicated disparities in health outcomes between Indigenous and non-Indigenous populations, but comprehensive data on sensory impairments were lacking. Understanding these disparities is crucial for developing targeted interventions.
Methods
The study employed a cross-sectional design with stratified, multistage, random cluster sampling across 30 sites in Australia. A total of 4519 participants were assessed for vision impairment (presenting visual acuity <6/12) and hearing impairment (pure tone average >25 dB HL). The primary outcome measures included age-standardised prevalence estimates calculated through multivariable logistic regression.
Results
The age-standardised prevalence of any vision impairment was 11·1% among Indigenous participants and 3·9% among non-Indigenous participants. The study reported that any vision impairment was 2·9-times more prevalent among Indigenous Australians. For hearing impairment, the age-standardised prevalence was 42·8% in Indigenous participants and 39·4% in non-Indigenous participants.
Interpretation
The findings indicate a significant gap in vision and hearing impairment between Indigenous and non-Indigenous Australians, consistent with previous literature highlighting health disparities. While the effect sizes are statistically significant, the clinical relevance may vary based on individual health contexts. Limitations include the cross-sectional nature of the study and potential confounding factors.
Key findings
- Age-standardised prevalence of any vision impairment was 11·1% (95% CI 8·4-14·5) among Indigenous participants.
- Age-standardised prevalence of any vision impairment was 3·9% (95% CI 3·3-4·6) among non-Indigenous participants.
- Any vision impairment was 2·9-times more prevalent among Indigenous than non-Indigenous Australians.
- Age-standardised prevalence of any hearing impairment was 42·8% (95% CI 36·8-49·5) in Indigenous participants.
- Age-standardised prevalence of moderate or worse hearing impairment was 14·3% (95% CI 11·0-18·4) in Indigenous participants.
- Among younger Indigenous participants aged 50-59 years, moderate or worse hearing impairment was 9·4% (95% CI 5·3-15·8).
Limitations
- Cross-sectional design limits causal inference.
- Reliance on self-reported data may introduce bias.
- Potential confounding factors not fully adjusted for.
- Not reported in abstract.