Health of People with Sight Loss: Secondary analysis using the Health Survey for England

The National Centre for Social Research (NatCen) were commissioned by the Royal National Institute of Blind People (RNIB) to produce a report aiming to establish whether, and how, the health outcomes and health-related behaviours of adults with sight loss differs from adults without sight loss.

Recent estimates indicate that around 1.9 million people in England are living with sight loss (Source: RNIB), equating to roughly 4% of the population. Sight loss can have an impact on many areas of people’s lives, including overall quality of life, mental and physical health, as well as health-related behaviours (e.g. smoking, vaping, drinking alcohol, fruit and vegetable consumption, physical activity), and these were all aspects of health explored in secondary analysis of Health Survey for England (HSE) data.

The Health Survey for England (HSE) provides valuable data on the health and social care behaviours of the nation on an annual basis. The HSE collects health and social care information from adults aged 16 and over, and children aged 0 to 15, living in private households in England. It provides annual statistics on key health conditions and measurements including height and weight, smoking status, general health, longstanding illness and acute sickness, with an opportunity for questions covering other aspects of health and social care. 

Given the vastness and richness of national health and social care data generated by the HSE over the last three decades, there is a wealth of opportunity for individuals and organisations wishing to explore health and social care behaviours of smaller groups and how these compare to other subgroups and the general population. For instance, we produced a report in 2021, on behalf of NHS England, which compared statistics on health and health-related behaviours of Lesbian, Gay or Bisexual (LGB) individuals and heterosexual adults, analysing data from the HSE between 2011 and 2018. More recently researchers at NatCen have used HSE data to investigate the health status and health-related behaviours of people with sight loss on behalf of the Royal National Institute of Blind People (RNIB). 

How does sight loss affect health and wellbeing? 

This secondary analysis combined data from five years of published HSE data (2015 to 2019), comparing responses for participants across four groups:  

• Experienced sight loss only
• Experienced sight loss and one or more other health conditions
• Experienced one or more health conditions other than sight loss
• Did not report any health conditions

Sight loss can often increase the negative effects of other health conditions (Source: Welp et al., 2016) with most people experiencing sight loss having comorbid health conditions (Source: Fight for Sight, 2020). Adults with sight loss in the HSE were around five times more likely to have bad or very bad general health compared to adults with no sight loss. Adults with sight loss were also more likely to report having other health conditions alongside sight loss, rather than sight loss only. HSE data indicates that adults with sight loss were more likely to have diabetes and hypertension, health conditions which already have an established link with eyesight (Sources: Diabetes UK, British Heart Foundation). 

Analysis also found that mental health varies by sight loss. Adults with sight loss were more likely to have General Health Questionnaire (GHQ-12, a widely used and validated measure of mental health) scores indicative of probable mental ill health compared to adults without sight loss. Those with sight loss were also around three times more likely to report low life satisfaction scores than those without sight loss. 

Sight loss, particularly when combined with other comorbid health conditions, can make it more challenging for individuals to perform health-related behaviours such as preparing nutritious meals and engaging in sufficient physical activity (Source: Crews et al., 2006). Analysis of the HSE found that adults with sight loss were less likely to consume five or more fruit or vegetables a day than adults with no sight loss or other impairments, with mean fruit and vegetable consumption lowest in adults with sight loss and other impairments. Adults with sight loss were also almost twice as likely to be ‘inactive’ (performing less than 30 minutes of exercise a week) compared to adults without sight loss. 

Whilst secondary analysis offers a great opportunity for those wanting to explore the attitudes and behaviours of smaller groups, it is limited by questions which were designed to serve the purposes and the objectives of the original research, which can leave gaps in the research. However, given the difficulty and challenges posed to researchers wishing to conduct large scale surveys of smaller groups, secondary analysis of larger datasets, such as the HSE, are a great resource, offering key insights which can aid researchers in the exploration of their research questions.

If you are interested in secondary analysis projects, using existing health and biomedical survey data, please contact NatCen’s Health and Biomedical Surveys team (Health&BioSurveys@natcen.ac.uk).