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Making Eye Health a Population Health Imperative: Vision for Tomorrow (2016)

Chapter: Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety

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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×

D

Examples of Federal Entities Involved
in Advancing Eye Health and Safety

Federal Entity Mission Examples of Activities Related to Eye Health
Administration for Children and Families (ACF) The entity within HHS responsible for overseeing federal programs that promotes “the economic and social well-being of children, families, individuals, and communities” (ACF, n.d.). The Office of Head Start promotes the Head Start and Early Head Start programs to support “comprehensive development of children from birth to age 5” (ACF, 2015b). The programs include early learning, health screening and follow-up, nutrition, social services, and services for children with disabilities (ACF, 2015a,b). Vision impairment and blindness are addressed in the eligibility criteria because they adversely affect learning outcomes (ACF, 2015a).
Administration on Aging “Promotes the well-being of older individuals by providing services and programs designed to help them live independently in their homes and communities” (AoA, 2015a). Provides home and community services to older persons, including programs related to “transportation, adult day care, caregiver supports, [and] health promotion programs” (AoA, 2015a).

“Manages health, prevention, and wellness programs for older adults. This includes behavioral health information, chronic disease self-management education programs, diabetes self-management, disease prevention and health promotion services, falls prevention programs . . . nutrition services, and oral health promotion” (AoA, 2015a).

Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Federal Entity Mission Examples of Activities Related to Eye Health
Advocates for changes at the local, state and national levels that will improve care and quality of life “for residents of nursing homes, board and care homes, assisted living facilities and similar adult care facilities” (AoA, 2015b).
Centers for Disease Control and Prevention (CDC) Aims to ensure public health through the control and prevention of safety and security threats (CDC, 2014). The CDC’s Division of Diabetes Translation contains a Vision Health Initiative that aims to optimize opportunities for addressing vision as a public health challenge (CDC, 2015a).

CDC is currently funding an effort to advance the surveillance of vision health (CDC, 2015b).

The CDC’s National Institute for Occupational Safety and Health supports programs promoting safe and healthy working conditions. The research programs are divided by industry sector (CDC, 2015c).
Centers for Medicare & Medicaid Services (CMS) Provides government funded health insurance to more than 100 million Americans through programs such as Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) (CMS, 2016a). Covers diagnosis, evaluation, and treatment of eye diseases and some vision costs, primarily if poor vision is the result of another illness or injury.

Relevant programs include
  • Center for Medicare & Medicaid Innovation conducts demonstration projects for potential program changes on the systemic and individual coverage determination level. These include projects aimed at home health pay, electronic health records, care management for high-cost beneficiaries, and low vision rehabilitation, among others (CMS, 2016c).
  • The early and periodic screening, diagnostic, and treatment (EPSDT) benefit for children, which provides at minimum coverage of the “diagnosis and treatment for defects in vision, including eyeglasses” (CMS, 2016b).
Health Resources and Services Administration (HRSA) Aims to achieve health equity and universal access to care by training HRSA provides programs targeted specifically at people who live in isolated areas and/or are economically or medically vulnerable (HRSA, 2016).
Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Federal Entity Mission Examples of Activities Related to Eye Health
health workers, researching important health care topics, and providing education to the public (HRSA, 2016). Relevant programs include (but are not limited to):
  • The National Health Service Corps, provides primary health care in underserved communities through incentivizing providers with loan repayment options (National Health Service Corps, 2016).
  • Bright Futures, which provides guidelines for the health supervision of children and adolescents and guides coverage of services managed by the EPSDT (AAP, 2016).
  • Federally qualified health centers (FQHCs) is a designation given to primary care service sites in underserved areas that provide a range of services to those who otherwise might lack access (HRSA, n.d.). Preventive services provided include glaucoma screening, diabetes screening, and the annual wellness visit (CMS, 2015).
Indian Health Service (IHS) Provides “health services to American Indians and Alaska Natives” (IHS, 2016). The IHS provides eye care on or near reservations. The services provided are for the most part by physicians and optometrists. Services include eye health promotion, eye exams, treatments, and prescription ophthalmic devices (IHS, 2016, n.d.).
National Institutes of Health (NIH) A biomedical research facility responsible for biomedical and health-related research (NIH, n.d.). The National Eye Institute (NEI) supports research as it pertains to improving knowledge about how the visual system works in health and disease, and pioneers advances in the prevention, management, and treatment of eye health (NEI, 2015).

The NEI’s National Eye Health Education Program increases awareness among health care professionals and the public about preserving eye health (NEHEP, n.d.).

Other institutes often fund vision-related research endeavors. These may include (among others):
Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Federal Entity Mission Examples of Activities Related to Eye Health
  • National Institute on Aging
  • National Institute of Neurological Disorders and Stroke
  • National Institute of Diabetes and Digestive and Kidney Diseases
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development
Office of Disease Prevention and Health Promotion Sets “national health goals and objectives and supporting programs, services, and education activities” (ODPHP, 2016a). Oversees Healthy People 2020, which includes vision-specific goals and recommendations (ODPHP, 2016b).
U.S. Department of Agriculture (USDA) Responsible for developing and executing government policy on farming, agriculture, forestry, and food (USDA, 2016). Researchers at the USDA promote eye health through studies that link eye disease to diet. For example, recently two age-related eye disease studies found that the use of a supplement containing vitamins C and E, lutein/zeaxanthin, and zinc delays progression to advanced age-related macular degeneration (AMD) (USDA, 2015).
U.S. Department of Defense (DoD) “To provide the military forces needed to deter war and to protect the security” of the United States (DoD, 2015). The DoD’s Defense Health Agency is an “integrated combat support agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force” through the provision of health services generally through the TRICARE Health Plan (DHA, 2016).

The DoD Vision Center of Excellence leads programs related to “improv[ing] vision health, optimiz[ing] readiness, and enhanc[ing] quality of life for Service members and Veterans” (VCE, 2016). Some of the activities include
  • Implementing a vision registry surveillance system that collects eye injury and vision dysfunction data from the DoD and the VA.
  • Promoting research for evidence-based prevention, diagnosis, mitigation, treatment, and rehabilitation.
  • Training the Tactical Combat Casualty Care workforce to improve care readiness for eye trauma and vision impairment.
Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Federal Entity Mission Examples of Activities Related to Eye Health
  • Expanding vision health education across involved parties (patients, families, clinicians).
  • Promoting “Shields Save Sight” campaign to advocate for protective eyewear.
  • Enhancing coordination of injured and visually impaired service members through the military health care system (VCE, 2016).
U.S. Department of Education (ED) Fosters “educational excellence and ensuring equal access” to education (ED, 2016a). Among other activities, houses the Office of Special Education and Rehabilitative Services (ED, 2016b), as well as the Helen Keller National Center, which provides services on a national basis to individuals who are deaf-blind, their families, and service providers (ED, 2014).
U.S. Department of Housing and Urban Development (HUD) “Create strong, sustainable, inclusive communities and quality affordable homes for all” (HUD, 2016c). Supports programs that “promote homeownership, support community development, and increase access to affordable housing, free from discrimination” (HUD, 2016b).

The HUD’s Office of Fair Housing and Equal Opportunity has information resources aimed at people with disabilities, housing providers, and building design professionals to disseminate regulations and policies aimed at shaping a built environment suitable for those with disabilities (HUD, 2016a).
U.S. Department of Labor (DOL) Responsible “to foster, promote, and develop the welfare of the wage earners, job seekers, and retirees of the United States; improve working conditions; advance opportunities for profitable employment; and assure work-related benefits and rights” (DOL, n.d.b). The Occupational Safety and Health Administration (OSHA) holds employers accountable, raises awareness about eye injury, and enforces eye safety in the workplace though the use of eye and face protective tools such as goggles and eye wash stations (DOL, n.d.a).

The Office of Disability Employment Policy (ODEP) provides assistance on the basic requirements of the Americans with Disabilities Act (ADA) (DOL, 2016).
Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
Federal Entity Mission Examples of Activities Related to Eye Health
U.S. Department of Transportation (DOT) Ensures a safe and effective transportation system. The DOT creates and enforces regulations on roads, railways, and seaways and in the skies (DOT, n.d.). Ensures that all drivers meet a certain standard of vision through mandatory vision exams, though there are state-by-state variations in vision requirements; for example, some states require all licensed drivers to have at least 20/40 vision with or without glasses or contacts, normal peripheral vision, and the ability to recognize colors on traffic signs and signals (FMCSA, n.d.).

The DOT enforces regulations governing transit under the ADA. These regulations are meant to ensure a user-friendly built environment for transportation services, and include designing accessible public transportation services and maintaining communication features such as fire alarms and signs (U.S. Access Board, 2006).
U.S. Department of Veterans Affairs (VA) Provides patient care and federally funded benefits to veterans and their families (VA, 2015a). VA patients who are visually impaired can apply for vision benefits “including clinical examinations, vision-enhancing devices, and specialized training in the use of innovative vision technology” (VA, 2016). Diagnosis, evaluation, and treatment are covered in those with eye diseases or injuries (VA, 2015b).
U.S. Environmental Protection Agency (EPA) “Protects human health and the environment” through science-based policies and enforcement (EPA, 2015b). Responsible for the classification, regulation, and labeling of eye irritants, such as pesticides and cleaning supplies, that if put in the eye can lead to vision loss and blindness (EPA, 2015a).
U.S. Food and Drug Administration (FDA) Ensures the safety of drugs, biologics, devices, food, tobacco, and cosmetic products (FDA, 2015). Provides regulation for pharmaceuticals and devices, such as contact lenses, intraocular lenses, and LASIK surgery on the public market (FDA, 2016).
Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×

REFERENCES

AAP (American Academy of Pediatrics). 2016. About. https://brightfutures.aap.org/about/Pages/About.aspx (accessed April 6, 2016).

ACF (Administration for Children and Families). 2015a. § 1308.13 eligibility criteria: Visual impairment including blindness. http://eclkc.ohs.acf.hhs.gov/hslc/standards/hspps/1308/1308.13%20%20Eligibility%20criteria_%20Visual%20impairment%20including%20blindness..htm (accessed April 6, 2016).

———. 2015b. Head Start services. http://www.acf.hhs.gov/ohs/about (accessed April 6, 2016).

———. n.d. Administration for Children & Families. https://www.acf.hhs.gov (accessed April 6, 2016).

AoA (Administration on Aging). 2015a. Administration on Aging (AOA). http://www.aoa.gov/ (accessed April 6, 2016).

———. 2015b. AOA programs. http://www.aoa.acl.gov/AoA_Programs/Elder_Rights/Ombudsman/index.aspx (accessed Ausgut 22, 2016).

CDC (Centers for Disease Control and Prevention). 2014. Mission, role and pledge. http://www.cdc.gov/about/organization/mission.htm (accessed August 22, 2016).

———. 2015a. About us. http://www.cdc.gov/visionhealth/about/index.htm (accessed April 6, 2016).

———. 2015b. Establish a vision and eye health surveillance system for the nation (RFA-DP-15-004). http://www.cdc.gov/chronicdisease/about/foa/visioneyehealthsurveillance/index.htm (accessed August, 22, 2016).

———. 2015c. NIOSH programs. http://www.cdc.gov/niosh/programs.html (accessed April 6, 2016).

CMS (Centers for Medicare & Medicaid Services). 2015. Preventive services chart. https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/Downloads/MPS-QuickReferenceChart-1TextOnly.pdf (accessed April 6, 2016).

———. 2016a. Centers for Medicare & Medicaid Services. https://www.cms.gov (accessed April 6, 2016).

———. 2016b. Early and periodic screening, diagnostic, and treatment. https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Early-and-PeriodicScreening-Diagnostic-and-Treatment.html (accessed April 6, 2016).

———. 2016c. Medicare demonstrations. https://innovation.cms.gov/Medicare-Demonstrations (accessed April 6, 2016).

DHA (Defense Health Agency). 2016. Defense Health Agency. http://www.health.mil/dha (accessed April 6, 2016).

DoD (U.S. Department of Defense). 2015. About the Department of Defense (DOD). http://www.defense.gov/About-DoD (accessed April 6, 2016).

DOL (U.S. Department of Labor). 2016. Disability employment policy resources by topic. https://www.dol.gov/odep/topics/ADA.htm (accessed April 11, 2016).

———. n.d.a. Occupational Safety and Health Administration. https://www.osha.gov/SLTC/etools/eyeandface/employer/requirements.html (accessed August 22, 2016).

———. n.d.b. Our mission. https://www.dol.gov/opa/aboutdol/mission.htm (accessed August 22, 2016).

DOT (U.S. Department of Transportation). n.d. About us. https://www.transportation.gov/about (accessed August 22, 2016).

ED (U.S. Department of Education). 2014. Helen Keller National Center. http://www2.ed.gov/programs/helenkeller/index.html (accessed August 28, 2016).

———. 2016a. About ED. http://www2.ed.gov/about/landing.jhtml (accessed April 6, 2016).

Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×

———. 2016b. Office of Special Education and Rahabilitative Services. http://www2.ed.gov/about/offices/list/osers/index.html (accessed August 28, 2016).

EPA (U.S. Environmental Protection Agency). 2015a. Alternate testing framework for classification of eye irritation potential of EPA-regulated pesticide products. https://www.epa.gov/pesticide-registration/alternate-testing-framework-classification-eye-irritationpotential-epa (accessed April 6, 2016).

———. 2015b. Our mission and what we do. https://www.epa.gov/aboutepa/our-mission-and-what-we-do (accessed July 14, 2016).

FDA (U.S. Food and Drug Administration). 2015. What we do. http://www.fda.gov/AboutFDA/WhatWeDo/ (accessed August 22, 2016).

———. 2016. Medical devices. http://www.fda.gov/MedicalDevices/default.htm (accessed April 6, 2016).

FMCSA (Federal Motor Carrier Safety Administration). n.d. Part 391 qualifications of drivers and longer combination vehicle (LCV) driver instructors. https://www.fmcsa.dot.gov/regulations/title49/section/391.41 (accessed August 22, 2016).

HRSA (Health Resources and Services Administration). 2016. About HRSA. http://www.hrsa.gov/about/index.html (accessed July 14, 2016).

———. n.d. What are Federally qualified health centers (FQHCs)?. http://www.hrsa.gov/healthit/toolbox/RuralHealthITtoolbox/Introduction/qualified.html (accessed August 22, 2016).

HUD (U.S. Department of Housing and Urban Development). 2016a. Fair housing and equal opportunity. http://portal.hud.gov/hudportal/HUD?src=/program_offices/fair_housing_equal_opp (accessed April 6, 2016).

———. 2016b. HUD’s vision. http://portal.hud.gov/hudportal/HUD?src=/hudvision (accessed April 6, 2016).

———. 2016c. Mission. http://portal.hud.gov/hudportal/HUD?src=/about/mission (accessed April 6, 2016).

IHS (Indian Health Service). 2016. Agency overview. https://www.ihs.gov/aboutihs/overview (accessed January 14, 2016).

———. n.d. Indian health manual. https://www.ihs.gov/ihm/index.cfm?module=dsp_ihm_pc_p3c9#3-9.2 (accessed July 14, 2016).

National Health Service Corps. 2016. The National Health Service Corps. http://www.nhsc.hrsa.gov (accessed April 6, 2016).

NEHEP (National Eye Health Education Program). n.d. NEHEP programs. https://nei.nih.gov/nehep (accessed August 22, 2016).

NEI (National Eye Institute). 2015. NEI’s research progress. https://nei.nih.gov/about/mission (accessed April 6, 2016).

NIH (National Insitutues of Health). n.d. Impact of NIH research. https://www.nih.gov/aboutnih/what-we-do/impact-nih-research (accessed August 22, 2016).

ODPHP (Office of Disease Prevention and Health Promotion). 2016a. About ODPHP. http://health.gov/about-us (accessed July 14, 2016).

———. 2016b. Vision. https://www.healthypeople.gov/2020/topics-objectives/topic/vision/ objectives (accessed April 6, 2016).

U.S. Access Board. 2006. ADA standards for transportation facilities. https://www.accessboard.gov/guidelines-and-standards/transportation/facilities/about-the-ada-standardsfor-transportation-facilities/ada-standards-for-transportation-facilities-single-file#a10 (accessed April 6, 2016).

USDA (U.S. Department of Agriculture). 2015. Lowering risk of a major eye disease. https://agresearchmag.ars.usda.gov/2015/may/eye (accessed April 6, 2016)

———. 2016. About the U.S. Department of Agriculture. http://www.usda.gov/wps/portal/usda/usdahome?navid=ABOUT_USDA (accessed April 6, 2016).

Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×

VA (U.S. Department of Veterans Affairs). 2015a. About VA. http://www.va.gov/about_va/mission.asp (accessed August 22, 2016).

———. 2015b. Chapter 1 health care benefits. http://www.va.gov/opa/publications/benefits_book/benefits_chap01.asp (accessed August 22, 2016).

———. 2016. VA vision care. http://explore.va.gov/health-care/vision (accessed April 6, 2106).

VCE (Vision Center of Excellence). 2016. About us. http://vce.health.mil/About-Us (accessed April 6, 2016).

Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×

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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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Suggested Citation:"Appendix D: Examples of Federal Entities Involved in Advancing Eye Health and Safety." National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press. doi: 10.17226/23471.
×
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The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult’s risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child’s social development, academic achievement, and better health across the lifespan.

The public generally recognizes its reliance on sight and fears its loss, but emphasis on eye and vision health, in general, has not been integrated into daily life to the same extent as other health promotion activities, such as teeth brushing; hand washing; physical and mental exercise; and various injury prevention behaviors. A larger population health approach is needed to engage a wide range of stakeholders in coordinated efforts that can sustain the scope of behavior change. The shaping of socioeconomic environments can eventually lead to new social norms that promote eye and vision health.

Making Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision health and health equity in the United States. Building on the momentum of previous public health efforts, this report also introduces a model for action that highlights different levels of prevention activities across a range of stakeholders and provides specific examples of how population health strategies can be translated into cohesive areas for action at federal, state, and local levels.

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