Title : Evaluating the impact of social vulnerability on the development and progression of diabetic retinopathy in New Orleans
Abstract:
This study investigates the association between the Social Vulnerability Index (SVI) and the development and progression of diabetic retinopathy (DR) among patients with type 2 diabetes mellitus (T2DM) in New Orleans. DR is a leading cause of vision loss in the United States, particularly among individuals with poorly controlled diabetes. Social determinants of health, including income, education, transportation, housing, and access to care play a critical role in both the development of diabetes and access to ophthalmology services. The Centers for Disease Control and Prevention (CDC) SVI is a composite measure of community resilience based on socioeconomic and demographic factors, publicly available at the ZIP code level. Given the wide variability in social vulnerability across New Orleans’ neighborhoods and the high burden of chronic disease in its medically underserved population, this study aims to assess whether higher SVI is associated with increased rates or severity of DR progression. This is a retrospective chart review of patients with DR secondary to T2DM seen between January 1, 2015 and June 25, 2025 at University Medical Center New Orleans (UMCNO) and the East Jefferson General Hospital (EJGH) Tulane Eye Care Clinic, both of which serve as safety-net institutions. Clinical and demographic data including patient age, sex, race/ethnicity, comorbidities, DR severity, and ZIP code were extracted from 4,398 eligible charts using ICD-10 coding. Patients’ ZIP codes were linked to their corresponding 2020 SVI Overall Percentile scores. The breakdown of patients by SVI percentile is as follows: 43 patients (SVI <24%), 139 patients (SVI 24–<49%), 558 patients (SVI 49–<74%), and 3,593 patients (SVI ≥74%). Sixty-five patients had no recorded SVI data. This distribution reflects the expected patient population of a safety-net health system and suggests a potential correlation between high social vulnerability and DR presence. Data extraction has been completed, and detailed chart review is currently underway, with statistical analysis to be performed in the coming weeks using logistic regression modelling. Preliminary findings suggest that higher SVI may be associated with increased prevalence of diabetic retinopathy, underscoring the importance of addressing structural inequities in chronic disease management and vision care. These findings may inform future care models and public health interventions aimed at reducing disparities in diabetic eye disease in New Orleans.
