500 Cities Initiative: Vision and Eye Health Community Responds to Lack of Vision Data

165 Organizations Send Letter to Key Public Health Leaders

In a recent letter to key public health leaders, 165 organizations across the vision and eye health community joined their voices to share their concern that vision data was not included in a new initiative aimed at assisting cities and local health departments to better understand the burden of health-related concerns in their communities.  Following is the complete text of the letter which was sent to the leadership of the CDC, the CDC Foundation, and the Robert Wood Johnson Foundation. 

Download a copy of the 500 Cities letter


April 6, 2017

Richard Besser, MD, President & CEO

Robert Wood Johnson Foundation

Judith Monroe, MD, FAAFP, President & CEO

CDC Foundation

Anne Schuchat, MD, RADM, USPHS, Acting Director

Centers for Disease Control and Prevention

Dear Drs. Besser, Schuchat, and Monroe,

On behalf of a broad spectrum of organizations whose collective interests are ensuring optimal vision, the eye health of our nation and our communities, and functional independence for those with vision loss, we thank the Centers for Disease Control and Prevention (CDC), the CDC Foundation, and the Robert Wood Johnson Foundation (RWJF) for your important work on the 500 Cities Project and the recent launch of your website 500 Cities:  Local Data for Better Health.  This will be a much needed asset for those working to improve the health of their local communities.  We are concerned, however, that vision and eye health was not included alongside the 27 chronic disease measures tracked. 

Eye health is highly valued across the lifespan – vision plays an important role in children’s success in school, adults’ employability, and older adults’ sustained independence.  And while many living with vision loss experience a quality of life equal to that of their sighted peers, according to one recent survey, Americans across all racial and ethnic lines describe losing vision as potentially having the greatest negative impact on their life (”Public Attitudes About Eye and Vision Health”).

According to RWJF’s own Chronic Care:  Making the Case for Ongoing Care, eye disorders are the fifth leading chronic condition among those aged 65 years and over and seventh across all age groups.  This same study finds that eye disorders are the third most prevalent chronic condition among children, behind only asthma and other upper respiratory disease.

We note that the 500 Cities initiative relies on data from the CDC Behavioral Risk Factor Surveillance System, the Census 2010 population, and the American Community Survey estimates.  While it is far from complete, there are avenues in each of these to gather vision-related information.  And where there are gaps, we encourage efforts to fill them.

The National Academies of Sciences, Engineering, and Medicine (NASEM) recently released a report that recognizes that for too long vision and eye health have not received the attention and investment they warrant, given their importance to public health (“Making Eye Health a Population Health Imperative:  Vision for Tomorrow”).

As we age, we are more likely to experience other chronic conditions such as diabetes, hearing impairment, heart problems, hypertension, joint symptoms, low back pain, and stroke at the same time as vision loss.  In the absence of high-quality rehabilitation and supports, these multiple conditions can lead to falls, injury, depression, social isolation, diminished health-related quality of life, and premature death.  However, many health initiatives at the community, city, and state levels do not fully take into account either the broad range of vision disorders and their comorbidities or their consequences for health and quality of life.

The above-mentioned NASEM report states that “vision impairment and blindness are appropriate targets for surveillance because they adversely affect a large portion of the population, affect populations unequally, can be improved by treatment and preventive efforts, and will become an increasing burden as the population ages.”

As you well know, surveillance is at the heart of public health.  The CDC’s Vision Health Initiative is currently supporting a project – The Vision and Eye Health Surveillance System.  We applaud this effort as an important step.  However, given the prevalence of vision problems and the many comorbidities thereof, we believe including vision problems alongside the 27 chronic disease measures currently in the 500 Cities Project will draw attention to the scope of this challenge and, more importantly, help lead to stronger interventions in our communities and states and have a major impact on the nation’s health.

As community partners in vision and eye health, we collectively acknowledge the good work of the 500 Cities Project and recommend that surveillance of vision concerns be added to this important initiative.


Signer Organizations

ACB of Wisconsin

Alabama Lions Sight Conservation Association

Alabama Vision Coalition

American Academy of Ophthalmology

American Academy of Optometry

American Association for Pediatric Ophthalmology and Strabismus

American Association of Diabetes Educators

American Association on Health and Disability

American Council of the Blind

American Council of the Blind of Nebraska

American Council of the Blind of New Mexico

American Foundation for the Blind

American Optometric Association

American Society of Ophthalmic Registered Nurses

Association for Education and Rehabilitation of the Blind and Visually Impaired (AER)

Association for Research in Vision and Ophthalmology

Association for the Blind & Visually Impaired

Association of Schools and Colleges of Optometry

Association of University Professors of Ophthalmology

Beaver County (PA) Association for the Blind

Bay State Council of the Blind

Blair/Clearfield Association for the Blind & Visually Impaired

Blind Association of Butler and Armstrong

Blind and Vision Rehabilitation Services of Pittsburgh

Blind LGBT Pride International


Bosma Enterprises

BrightFocus Foundation

Bucks County (PA) Association for the Blind & Visually Impaired

Byers Eye Institute at Stanford University

Cahaba Valley Health Care

Cambria County (PA) Association for the Blind & Handicapped

Case Western Reserve University School of Nursing

Casey Eye Institute, Oregon Health and Science University

Center for the Visually Impaired, Atlanta

Center for the Blind and Visually Impaired, Pennsylvania

Center for Vision Loss

Central Susquehanna Sight Services

Central Ohio Lions Eye Bank

Cincinnati Association f/t Blind & Visually Impaired

Cincinnati Eye Institute

Cincinnati Eye Institute Foundation

ClearVision Optometry – VisionSource network

Columbia River Services for the Blind

Combat Blindness International, Inc.

Community Services for Sight

Department of Ophthalmology, Georgetown University School of Medicine

Department of Ophthalmology, NYU Langone Medical Center

Department of Ophthalmology, Rutgers-New Jersey Medical School

Department of Ophthalmology, University of Alabama Birmingham

Department of Ophthalmology, University of California San Francisco

Department of Ophthalmology, University of Florida

Department of Ophthalmology, University of Kansas Medical Center

Department of Ophthalmology, University of North Carolina at Chapel Hill

Department of Ophthalmology, University of Pittsburgh

Department of Ophthalmology & Visual Sciences, Case Western Reserve University

Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin

Department of Ophthalmology & Visual Sciences, University of Louisville, Kentucky

Duke University Eye Center

Emory Eye Center

Eye Bank Association of America

Eyesight Foundation of Alabama

Family Vision Center

Fayette County (PA) Association for the Blind

Florida Association of Agencies Serving the Blind, Inc.

Florida Council of the Blind

Florida Lions Conklin Center for the Blind

ForSight Vision

Georgia 2020

Georgia Lions Lighthouse Foundation

Greater Wilkes-Barre Association for the Blind

Guide Dog Users, Inc.

Guide Dogs of Hawaii

Guiding Eyes for the Blind

Hadley Institute for the Blind and Visually Impaired

Healthy Eyes Alliance

Helen Keller International

Honolulu District School Visual Impairment Program

Houston Health Department

Houston Health Foundation

Illinois College of Optometry

Illinois Society for the Prevention of Blindness

Independence for the Blind

International Agency for the Prevention of Blindness

International Eye Foundation

International Retinal Research Foundation

John Moran Eye Center

Kansas Society of Eye Physicians and Surgeons

Keystone Blind Association

Lackawanna Association for the Blind

Lavelle Fund for the Blind

Lighthouse Guild

Lighthouse Louisiana

Macula Vision Research Foundation

Macular Degeneration Partnership

Macular Degeneration Support

Missouri Council of the Blind

Montgomery County (PA) Association for the Blind

National Alliance for Eye and Vision Research

National Center for Children’s Vision and Eye Health at Prevent Blindness

National Keratoconus Foundation

Nationwide Children’s Hospital

Nevada Council of the Blind

New England College of Optometry

New England Eye Center, Tufts Medical Center

NOAH – National Organization for Albinism and Hypopigmentation

North Central Sight Services

Northgate Eye Center

NuVisions Center


Ohio Public Health Association

Opticians Association of Ohio

Pennsylvania Association for the Blind

Pennsylvania College of Optometry/Salus University

Pennsylvania Council of the Blind

Perkins School for the Blind

Prevent Blindness

Prevent Blindness Georgia

Prevent Blindness Iowa

Prevent Blindness North Carolina

Prevent Blindness Northeast Region

Prevent Blindness Northern California

Prevent Blindness Texas

Prevent Blindness Wisconsin

Prevent Blindness, Ohio Affiliate

Reader’s Digest Partners for Sight Foundation

Red Rose Council of the Blind

Research to Prevent Blindness

River Region Vision Source

San Antonio Lighthouse for the Blind

Script Your Future Alabama

SEE International

Seva Foundation

Shiley Eye Institute, University of California San Diego

Sight Center of Northwest Pennsylvania

Sight Savers America


South Central Blind Association

State University of New York College of Optometry

Tennessee Council of the Blind

That Man May See

The Vision Council

UAB Vision Science Research Center

University of Alabama at Birmingham School of Optometry

University of Houston College of Optometry

University of Pikeville, Kentucky College of Optometry

UPMC (University of Pittsburgh Medical Center)

Utah Councils of the Blind

UTMB Galveston

Venago County (PA) Association for the Blind

Virginia Tech Advanced Research Institute


Vision 2020 USA

Vision Forward Association

Vision Resource Center of Berks County (PA)

Vision Resources of Central Pennsylvania

Vision Source

VISIONS/Services for the Blind and Visually Impaired

VisionServe Alliance

Visually Impaired Persons Support (VIPS)

Washington-Greene County (PA) Blind Association

Westmoreland County (PA) Blind Association

West Virginia University Eye Institute

Wills Eye Hospital

Wyoming Council of the Blind

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