Abstract
Background/Objectives: As the world becomes more connected, it is becoming critical for clinicians to understand other cultures, races, and ethnicities to provide the most effective therapy. A comprehensive understanding of all communities necessitates an examination of the social determinants of health (SDH). Eye diseases and many other conditions are influenced by SDH. To elucidate the impact of SDH on eye health, a comparative ecological analysis of Monroe and Erie Counties in New York State was conducted to identify any differences in SDH and glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy prevalence. Methods: The CDC Vision and Eye Health Surveillance System (VEHSS) was utilized to collect glaucoma, AMD, and diabetic retinopathy data in Monroe and Erie Counties, New York State, and the USA for 2019. The American Community Survey, County Health Rankings, and Neighborhood Atlas data portals were used to collect the county socioeconomic demographics, along with other health statistics. Results: Overall, Erie County had a higher prevalence of AMD (9.56% vs. 6.61%, p < 0.0001) and glaucoma (13.05% vs. 11.71%, p < 0.0001) compared to Monroe County. Erie County also had a higher prevalence of AMD and glaucoma across all races, aside from North American Natives. Erie County also had a greater primary care shortage, with only 1 primary care physician for every 1230 individuals. Although income inequality and poverty were similar between Erie and Monroe Counties, Erie County also has more racial segregation regarding the residential layout (ranked 74 on a scale of 0 to 100, with 100 being the most segregated). Conclusions: The results indicate that Erie County had an increased prevalence of AMD and glaucoma compared to Monroe County in 2019, along with a greater primary care shortage. Although this analysis targeted Western New York, disparities such as lack of primary care access and segregation are prevalent across the US, necessitating widespread action to address these problems.