Abinethaa Paramasivam is a graduate of the Biomedical Sciences co-op program and Food Security Certificate program at Ryerson University. She has held positions both locally and internationally as a Research Assistant at the University of Toronto and University College London. Currently, Abinethaa is a Research Assistant at the University of Montreal’s School of Optometry supporting research related to deafblindness.
Social Determinants of Health and Inequities in Health for Older Adults with Dual Sensory Loss
Abinethaa Paramasivam Université de Montréal, Canada
Hannah Ertel and Renu Minhas, DeafBlind Ontario Services, Canada
Atul Jaiswal, CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Canada
Walter Wittich, CRIR/Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Canada
The World Health Organization (WHO) defines social determinants of health (SDH) as “non-medical factors that influence health outcomes.” SDH are intertwined in social and political systems as policies, agendas, and norms that influence inequities in an individual’s health status. Dual sensory loss (DSL) is a unique condition where individuals have combined vision and hearing loss. DSL has a substantial and often neglected impact on people’s overall health and wellbeing, employment, social inclusion, mobility, independence, and access to services. This review will present a synthesis of scientific evidence on reported indicators of SDH and related inequities among older adults with DSL.
Five scientific databases (Medline, Embase, CINAHL, PsycINFO, and Central) were searched from February 2011 to February 2021. Using the Covidence screening tool, articles were assessed at the title/abstract and full-text level. Studies were included if the studied population was older adults with DSL and if the paper covered aspects related to SDH. Articles that met the inclusion criteria were extracted into a logbook by two authors. Descriptors of the logbook included study population, methods of data collection, sociodemographic characteristics, 11 indicators of SDH and significant findings.
Eighty-one studies focused on older adults with DSL and included a SDH. Since this review focused on individuals with DSL, all studies had disability as a factor of SDH. Seventy-six of the studies had included social inclusion and non-discrimination. Forty-one studies included education, and 22 studies examined income and social protection in individuals with DSL. Only two studies included individuals with DSL with Aboriginal status. No studies examined structural conflict or food insecurity in individuals with DSL. Additionally, 79 of the studies were from developed countries, with most studies being conducted in North America and Europe.
This review identifies a significant need for further research to develop a robust understanding of how inequities based on SDH influence older adults with DSL. This is imperative to inform the designing of policies/programs to address those inequities. Furthermore, the review found that the experiences of each individual varied based on other SDH, leading to the intersectionality between each SDH. There remains a pressing need to raise awareness on DSL as there is no single overarching strategy for vision and hearing health and how inequities of the SDH influence the prevalence and impact of DSL.