Socioeconomic and environmental factors associated with glaucoma in an African Ancestry Population: findings from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study.

Background/objectives: Glaucoma is the leading cause of irreversible blindness, disproportionately affecting individuals of African ancestry. Limited research has examined the impact of neighbourhood quality and socioeconomic factors on primary open-angle glaucoma (POAG) risk in this population. This study aims to address these gaps by evaluating associations between ocular health and neighbourhood characteristics using geospatial data.

Subjects/Methods

We conducted a case-control study with 5192 African ancestry individuals from the Philadelphia area using data from the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study. Geocoded U.S. Census data were merged with individual-level demographics and neighbourhood-level measures, including air quality, food accessibility, and socioeconomic indicators, to assess their association with glaucoma risk and severity.

Results

The study included 3039 controls (58.5%) and 2153 POAG cases (41.5%). Higher POAG risk was associated with older age (OR 1.72 per 10-year increase, p < 0.001), male gender (OR 2.04, p < 0.001), lower BMI (OR 0.87 per 10 kg/m 2 increase, p = 0.003), and nonuse of alcohol (OR 0.56 for alcohol use, p < 0.001). Low food access was more common in controls (OR 0.86, p = 0.03), and severe POAG cases were associated with lower homeownership rates (OR 0.95 per 10% increase, p = 0.049). However, most socioeconomic and environmental factors (air quality, education, income, occupation, family structure) were not significantly linked to POAG risk or severity.

Conclusion

Socioeconomic status did not significantly protect against POAG in African ancestry individuals. Individual factors were more influential, suggesting neighbourhood and socioeconomic factors may have a lesser impact than previously hypothesised.