Chapter 6: Ear, Eye, Nose, Throat, and Dental Health
Chapter 6: Ear, Eye, Nose, Throat, and Dental Health
Gillian Spring
Background
Access to consistent eye care, dental care, and hearing assessments is not always possible for low-income individuals, immigrants, and refugees. The costs of hearing aids, glasses/contacts, and dental work may not be feasible for low-income households. Essential items such as food and shelter may take precedence.
During hospitalization, health care providers (HCPs) can watch for subtle cues of vision and hearing loss and dental decay in their patients during daily assessments and interactions. With this information, HCPs can provide additional community support to patients with these types of issues.
Social Determinant Considerations and Culturally Responsive Practice Points for Health Care Providers
Eyes
Along with social and demographic considerations, African ancestry is a risk factor for primary open-angle glaucoma (Cole et al., 2021). Globally, primary open-angle glaucoma is the leading cause of irreversible blindness (Cole et al., 2021). Patients with African ancestry have thinner central corneas, which can lead to the inability to measure intraocular pressure accurately, and misdiagnosis (Cole et al., 2021).
Diabetic retinopathy is a microvascular complication of diabetes that causes visual impairment and even blindness (Lui et al., 2020). Along with blood sugar control, blood pressure is also an important risk factor in diabetic retinopathy (Lui et al., 2020). Diabetes and hypertension are more prevalent among certain cultural groups, and there are clear disparities in the diagnosis and treatment of these diseases (Lui et al., 2020). Please refer to the cardiovascular and endocrine sections of this text for further information. While caring for patients with diabetes and hypertension, HCPs should be vigilant in assessing for visual disturbances. See the list below for common signs of vision loss.
They experience a greater impact on their quality of life and emotional well-being as a result (Grisafe et al., 2021). In their study, Grisafe et al. (2021) discovered that Black participants were mostly affected by their inability to complete visual tasks such as driving. Poor vision can also greatly impact an individual’s ability to participate in activities of daily living (ADLs) such as bathing, dressing, toilet hygiene, and other activities such as household chores, shopping, cooking, and transportation throughout the community (Umfress & Brantly, 2016). Vision loss may also lead to decreased participation in religious or social events, which could be very isolating for many individuals (Umfress & Brantly, 2016).
The World Health Organization (2022a) has stated that individuals from low- and middle-income settings have a greater burden of vision loss due to fewer opportunities to access eye care. In turn, these individuals may experience an even greater impact on their quality of life and ability to provide for and support family.
Furthermore, elderly people resi