Last year, the VisionServe Alliance (VSA) released their Big Data Project report on older adults in Wisconsin with vision loss. That report confirmed what the Council has long known: Vision loss in Wisconsin is more prevalent than most people realize, and vision services are not meeting the level of need.
VSA has now released a second set of Big Data reports, focusing on working age adults ages 18 to 64 with blindness and low vision. The report further highlights the stark reality of the state of vision loss in Wisconsin, showing that much more needs to be done to enable people with vision loss of all ages to live full, independent lives.
“The power of data like this is that it shows people this isn’t an individual problem. It’s a systemic problem,” Executive Director Denise Jess of the Council says. “It’s not about a lack of character or individual fortitude to overcome challenges. We have structural issues around things like transportation and health equity that diminish people’s quality of life.”
According to the report:
- 91,785 working age adults in Wisconsin report having some form of serious vision loss.
- 48.6% of working age adults with blindness or low vision are currently working, compared to 73.9% of working age adults without vision loss.
- 40.6% of working age adults with vision loss report that they are unable to work, compared to 5.6% of other working age adults.
- 72.5% of working age adults who are blind or have low vision earn less than $35,000 a year, compared to 25% of working age adults without vision loss.
- 21.1% of working age adults with vision loss did not graduate high school, compared to 8.1% of other working age adults.
The report goes on to summarize the physical and mental health of working age adults with vision loss.
- 52.7% of working age adults with vision loss report having fair or poor health, compared to 12.8% of working age adults without vision loss.
- 39% of working age adults who are blind or visually impaired report their physical health was “not good” for at least two weeks over the past 30 days, compared to 10% of working age adults without vision loss.
- 48.1% of working age adults with vision loss report their mental health was “not good” for at least two weeks over the past 30 days, compared to 14.1% of other working age adults.
- Working age adults with vision loss who say they are unable to work have significantly higher rates of hearing loss, diabetes, depression, kidney disease and strokes compared to those who are working.
This information presents a spiderweb of interconnected issues that the Council will continue to address through our advocacy. “This is very sobering data, especially when you look at the health outcomes of people who are working versus the health outcomes of those who are unable to work,” Denise says. “It is so important for people who say they cannot work to get what they need to be able to work. We must continue to collaborate with other service providers and lawmakers to get the word out that these are people who want to work but have barriers preventing them from doing so.”
One of the biggest barriers is transportation equity. Accessible transportation options are extremely limited in many parts of the state, especially rural areas. In some parts of Wisconsin, if you can’t drive somewhere, then you simply cannot go there.
While many, though not all, communities do have some options available to nondrivers, the destinations where they will take riders are sometimes limited. For example, they may put most of their resources toward getting people to medical appointments, with significantly fewer resources available for work, social and shopping-related trips. More funding for these transportation options is needed, especially in rural areas, which could enable providers to make services more flexible.
Another way to address this issue is to remove the need for a trip entirely by allowing people to participate in jobs and health care virtually to the degree possible. While this opens the door to other challenges, such as access to broadband internet, allowing people with vision loss to skip the trip can increase access to employment and healthcare while saving them money in transportation costs.
Additionally, most insurance providers, including Medicare and Medicaid, do not cover critical vision services such as those provided by the Council. While the Council does not turn people away due to inability to pay, that leaves the organization on the hook for the costs of those services. The lack of insurance coverage discourages people with limited income from seeking out these important services.
The issue goes beyond physical health. Many mental health providers do not accept Medicaid, meaning someone with vision loss might have to secure transportation to travel over an hour away to see a mental health professional who accepts their insurance. The Council is working hard at both the state and federal levels to expand Medicare and Medicaid eligibility and extend coverage of vision services by these programs.
Lack of coverage is not the only barrier to accessing vision services. There is a severe shortage of vision services professionals in Wisconsin, as well as across the nation as a whole. There is a severe shortage of vision services professionals across the state, and the professionals in Wisconsin tend to be concentrated in major urban areas like Madison and Milwaukee. While the Wisconsin Office for the Blind and Visually Impaired (OBVI) serves the entire state, their staff is stretched thin, and they tend to focus their services on older adults. The Wisconsin Department of Workforce Development’s Division of Vocational Rehabilitation provides important employment services to working-age adults across the state, but they too have limited capacity, relying on organizations like the Council and Vision Forward to support clients with access technology instruction and orientation and mobility training. Consequently, many working-age adults with vision loss, especially those living in rural areas, are unable to access the resources and services they need to live independently and maintain employment.
Wisconsin is in desperate need of more vision service professionals. While allowing vision services to be covered by insurance would certainly help, the other part of the solution is to expand the pool of professionals who can provide vision services. One option would be to encourage occupational therapists (OTs) to receive the necessary specialized training to teach these skills. Not only would this expand the number of vision services professionals, but because OTs can accept payments from Medicaid, more people would be able to access these services.
Finally, more needs to be done to get people who are blind or have low vision into the workforce. Not only would this help boost the state’s economy, but the data clearly shows that people with vision loss who are working have significantly better health outcomes and quality of life than those who are unable to work.
Access to vision services can provide the skills people need to succeed in the workforce. That includes things like orientation and mobility training and access technology instruction. It also means mastering daily living skills, like managing a calendar and dressing appropriately for the workplace.
Another critical skill is effective self-advocacy. While every workplace should be accommodating for people with any type of disability, the reality is that many employers have unconscious biases that create barriers for workers with vision loss. Learning to speak up about the accommodations one needs to do their job effectively is a key to success.
“There’s such a lack of understanding from employers and from the community in general that with those tools and skills, those doors open,” Denise says.
Denise emphasizes that they kind of information the Big Data Project has provided has help fuel our efforts to create change tremendously.
“We aren’t looking at this data for you to feel bad about it,” Denise says. “Instead, it shapes how we look at our healthcare and transportation systems. We at the Council can teach people the skills, but without these system changes they will still be sick and struggle getting to where they need to go.”
You can read the full Big Data Report on Working Age Adults at VisionServeAlliance.org/Big-Data-Reports-Working-Age-Adults. You can learn more about all the Council’s advocacy efforts on our website at WCBlind.org/Advocacy.
