Association between Household Income and Glaucoma Prevalence in South Korea: A SMOTE-Enhanced Analysis of KNHANES 2021

Purpose: To investigate the association between household income and glaucoma prevalence in a representative Korean population using data from the 2021 Korea National Health and Nutrition Examination Survey (KNHANES).Methods: We analyzed data from 2,923 participants aged 19 years who completed ophthalmologic examinations.Glaucoma was diagnosed based on the International Society for Geographic and Epidemiological Ophthalmology criteria.Household income was categorized into quartiles.Multiple logistic regression analyses were performed to examine the association between income level and glaucoma, adjusting for potential confounding factors.The Synthetic Minority Over-sampling Technique (SMOTE) was employed to address class imbalance in the dataset.Results: The overall prevalence of glaucoma was 2.8%.Unexpectedly, lower income levels showed significantly lower odds of glaucoma compared to the highest income quartile.After adjusting for age, sex, hypertension, diabetes mellitus, body mass index, and self-rated health, the odds ratios (ORs) for glaucoma were 0.111 (95% confidence interval [CI], 0.063-0.196)for the lowest quartile, 0.170 (95% CI, 0.125-0.230)for the second quartile, and 0.279 (95% CI, 0.225-0.346)for the third quartile, compared to the highest quartile.Diabetes mellitus (OR, 1.668; 95% CI, 1.439-1.933)and hypertension (OR, 1.195; 95% CI, 1.061-1.345)were significantly associated with increased odds of glaucoma.Conclusions: Higher household income was associated with increased glaucoma prevalence in the Korean population, contrary to typical socioeconomic health disparities.