Breanna N. Aldred, MD; Suzanne W. van Landingham, MD
WMJ. 2026;125(2):245-250. Published June 2, 2026.
ABSTRACT
Introduction: Studies have found that the odds of visual impairment decrease as affluence increases. This retrospective cross-sectional study evaluates the association between poverty status and visual impairment in Wisconsin.
Methods: The Survey of the Health of Wisconsin (SHOW) is a household-based study that collects health and demographic data from a representative sample of Wisconsin residents. Participants with demographic, income, and vision data collected at Timepoint 1 (2008-2013) were included. Self-reported eyesight quality was categorized into visual impairment scores: none/mild, moderate, and severe. Univariable and multivariable logistic regression models, adjusting for demographic characteristics, were used to evaluate the association of visual impairment with poverty status. Longitudinal analysis investigated the relationship between visual impairment and incident poverty for participants with Timepoint 2 (2017) data.
Results: There were 3292 participants included in Timepoint 1 analysis. Multivariable analysis revealed that poverty was associated with visual impairment: compared with those with no/mild visual impairment, those with moderate visual impairment had greater odds of living in poverty [Odds Ratio (OR), 2.43; 95% CI, 1.59-3.71; P < .001], as did those with severe visual impairment (OR, 2.69; 95% CI, 1.26-5.72; P = .01). Among 706 participants in the longitudinal analysis, visual impairment was associated with incident poverty: those with moderate visual impairment were more likely to become impoverished over time compared with those without visual impairment (OR, 2.79; 95% CI, 1.01-7.77; P = .05).
Conclusions: Poverty is associated with subjective visual impairment in Wisconsin. Subjective visual impairment is also associated with incident poverty, suggesting a bidirectional relationship between poverty and vision impairment.