A vision for addressing social needs and social determinants of health

Afaro Hudak and colleagues describe the association between vision loss in adolescents and adults and social determinants of health (SDOH) in a cross-sectional analysis of 3 nationally representative data sets. Although there was variability in how vision loss was categorized, including only 1 data set that directly assessed visual acuity, and variability in how SDOH was measured, the findings were consistent: adverse social risk factors were associated with worse vision. This is an important finding, but also expected. It is hard to identify a health outcome that is not influenced by social risk factors. The real question is how these results can be used to improve population health. We suspect that many readers of the article by Alfaro Hudak and colleagues, while aware of the challenges related to SDOH, engage with their patients to help improve access to timely and high-quality ophthalmologic care. This is commendable but will not be successful in addressing the fundamental problems created by disparate social factors.