Area deprivation and age related macular degeneration in the EPIC-Norfolk Eye Study

Jennifer L.Y. Yip*, Anthony P. Khawaja, Michelle P.Y. Chan, David C. Broadway, Tunde Peto, Robert Luben, Shabina Hayat, Amit Bhaniani, Nick Wareham, Paul J. Foster, Kay Tee Khaw

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Objectives: To investigate the relationship between area deprivation, individual socio-economic status (SES) and age related macular degeneration (AMD). Study design: Cross sectional study nested within a longitudinal cohort study. Methods: Data were collected in the EPIC-Norfolk Eye Study by trained nurses, using standardized protocols and lifestyle questionnaires. The English Index of multiple deprivation 2010 (IMD) was derived from participants' postcodes. AMD was identified from standardized grading of fundus photographs. Logistic regression was used to examine associations between IMD, SES and AMD. Results: 5344 pairs (62.0% of total 8623) of fundus photographs were of sufficient quality for grading of AMD. Of 5182 participants with complete data, AMD was identified in 653 participants (12.60%, 95%CI=11.7-13.5%). Multivariable logistic regression showed that people living in the most affluent 5% of areas had nearly half the odds of AMD compared to those living in comparatively more deprived areas (OR=0.56, 95%CI=0.36-0.89, P=0.02), after adjusting for age, sex, education, social class and smoking. Conclusions: The authors found that living in the most affluent areas exerted a protective effect on AMD, independently of education and social class. Further investigation into underlying mechanisms will inform potential interventions to reduce health inequalities relating to AMD.

Original languageEnglish
Pages (from-to)103-109
Number of pages7
JournalPublic Health
Issue number2
Publication statusPublished - 1 Feb 2015
Externally publishedYes

Bibliographical note

Funding Information:
EPIC-Norfolk infrastructure and core functions are supported by grants from the Medical Research Council ( G0401527 ) and Cancer Research UK ( C864/A8257 ). The clinic for the third health examination was funded by an Age UK Research into Ageing grant ( 262 ). The pilot phase was supported by Medical Research Council ( G9502233 ) and Cancer Research UK ( C864/A2883 ). Dr Yip is a National Institute for Health Research (NIHR) Clinical Lecturer. Dr Khawaja is a Wellcome Trust Clinical Research Fellow. Michelle Chan is an MRC/RCOphth Clinical Training Felllow and has received additional support from the International Glaucoma Association. Professor Foster has received additional support from the Richard Desmond Charitable Trust (via Fight for Sight). Professor Foster and Tunde Peto received funding from the Department for Health through the award made by the NIHR to Moorfields Eye Hospital and the UCL Institute of Ophthalmology for a specialist Biomedical Research Centre for Ophthalmology. None of the funding organizations had a role in the design or conduct of the research.

Publisher Copyright:
© 2014 The Authors.


  • Area deprivation
  • Inequalities
  • Macular degeneration


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