NEW YORK—With millions of Americans facing job losses and other economic hardships resulting from the pandemic, providing access to healthcare for those in need has taken on new urgency. The crisis is prompting healthcare policy makers and researchers to sharpen their focus on the underlying causes that prevent many people from getting the healthcare services they need. In a new video, “Access to Care: The Social Determinants of Health,” VM editorial director Marge Axelrad and lens and technology editor Andrew Karp discuss this timely topic and how it impacts vision care. The video, the third in a series of “Micro Chats on Macro Topics,” can be viewed here.

“The pandemic showed in sharper relief the distinctions between the ‘haves’ and ‘have nots,’” Axelrad observed. “The haves—people who have access to a high speed internet connection or who have jobs that afford them healthcare coverage—have a very different perception of their healthcare interactions than people who have lost their jobs, people who haven’t had regular care, people who do not have insurance, people who don’t have a way of getting to healthcare professionals in ways that can they manage for their families.”

Axelrad cited the growing importance of what health economist Jane Sarasohn-Kahn calls “health care citizenship.” Speaking at the 2020 Vision Monday Global Leadership Summit, she described health citizenship as, “Giving people the tools to manage their health and their families’ health.”

A person’s level of education, the type of work they do, and their income level are among the social determinants of health. “There are many barriers to accessing care, including vision care, particularly for people in low income households,” said Karp. “A recent study by Versant Health found that 81 percent of all respondents say they have received an eye exam in the past two years, but only 68 percent of people in households with incomes under $35,000 say the same.”

He noted, “There’s a growing understanding that eye exams are essential not only for a patient’s ocular health, but for their overall health and wellness as well. A good example is the diagnostic testing used to detect diabetic retinopathy. That’s why access to eyecare is so important.”

At the end of the Micro Chat, Axelrad and Karp asked viewers, “How does a greater awareness of social/cultural/economic inequities create new opportunities for you to better serve patients and families in your community?” Email us your answer at

The weekly Micro Chat video series feature Axelrad and Karp talking about big ideas and trends from the 2020 VM Leadership Summit that continue to reverberate throughout optical and healthcare in 2021. In their first conversation, titled Brick Learns to Click, they discuss how boundaries between the physical and virtual worlds are blurring in today’s healthcare environment. Their second Micro Chat, Telehealth and Wellness explores the rise of telehealth and a crescendo of patients' interest in staying healthy and learning more about their own wellness.

Upcoming Micro Chats will explore the following themes:

• Re-Establishing Trust in Healthcare
• Optometry’s Widening Scope
• The Retail-Healthcare Convergence

VM will post a new conversation each week. To watch the Micro Chats, visit the VM Leadership Summit site.