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Study shows positive trend in ability to afford eyeglasses in US
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Data analysis of a large survey suggests that Americans have experienced less difficulty affording eyeglasses since 2014, possibly due to the economic recovery and health care reform. However, some gender and racial differences persist.
Representative data were gathered from the National Health Interview Survey (NHIS) over a 9-year period from 2008 to 2016 with the aim of assessing trends in using eye care services (consultations with optometrists or ophthalmologists) and difficulties in affording spectacles in the U.S. Annual population samples varied in size from 21,781 to 36,697 participants, 18 years old or older.
Results showed decreased difficulty in affording eyeglasses from 2014 to the end of the study, while no significant change was noted in the use of eye care services from 2008 to 2016.
“It is important to note disparities in these results. For example, individuals with self-reported visual impairment were more likely to use eye care but had greater difficulty affording eyeglasses than those without visual impairment,” Bonnielin K. Swenor, PhD, study co-author, told Primary Care Optometry News.
Older Americans were generally more likely to have less difficulty in affording spectacles, possibly reflecting the use of inexpensive reading glasses purchased in department stores. Women were more likely to use eye care services but more likely to experience difficulty in affording eyeglasses. According to the authors, this might reflect sex disparities in income and economic decision-making.
Interestingly, individuals with college education had, on average, greater difficulty in affording eyeglasses than individuals with less than high school education. The authors hypothesized that higher education might be related with a better perception of the need for spectacles or with less coverage by government-sponsored insurance schemes. Asian, Black and Hispanic ethnicity was associated with lesser use of eye care services, but Asian and Black individuals were less likely to have difficulty affording eyeglasses, also compared with non-Hispanic white individuals.
“We cannot discern from this data set the reasons for this trend and would need further data to know if the trend continues. However, we are exploring additional research to better understand the driving factors,” Swenor said.
“We speculate that perhaps the decrease in difficulty affording eyeglasses observed in recent years may be related to postrecession economic recovery,” the authors wrote. “Another plausible explanation is the influence of the provisions of the Affordable Care Act and 2014 Medicaid expansion.” – by Michela Cimberle
Disclosure: The authors reported no relevant financial disclosures.
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Clarke Newman, OD, FAAO
Dr. Varshini Varadaraj and colleagues detailed their analysis of nine cross-sectional population-based studies on the trends in eye care use and eyeglasses affordability from 2008 to 2016. Overall, study participants had less difficulty affording eyeglasses in the years 2014 to 2016 than at other times.
In general, the findings were not surprising. Older patients and those with visual impairment used eye care more. Older white males were in the best position to afford eye wear. Younger age, being female, having poor health and lower economic class were risk factors for having difficulty affording eyeglasses. Ironically, those with visual impairment also had difficulty accessing eye care and affording needed vision correction.
While this survey is timely, it does have some limits. The study is not longitudinal. Participants in year 1 were not necessarily counted in subsequent years. Also, the difficulty affording eyeglasses was likely overestimated, as the denominator included people who did not need eyeglasses. Finally, all of the data is self-reported.
This study supports the need for health policy to focus on improving eye care access and affordability, particularly in socially, racially, economically and gender marginalized groups.
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