Comprehensive vision care found lacking in children, despite economics, geography
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SAN DIEGO — A study of pediatric screening and referral completion rates in Ohio found that comprehensive vision care is lacking, regardless of socioeconomic status or geography.
Erica Shelton, OD, MS, who is pursuing her PhD at The Ohio State University College of Optometry, spoke about her research at a virtual press conference during Academy 2022.
The five social determinants of health as defined by HHS in the 1990s include education access and quality, economic stability, health care access and quality, neighborhood and built environment, and social and community context.
“These may or may not be something people can control,” Shelton said at the Academy-sponsored event.
The researchers sought to determine how economic stability, insurance status and demographic measures are associated with vision testing and unmet vision care need.
They used data from the 2016-2022 National Survey of Children’s Health to look at age, sex and household income and how they were related to vision test reporting. They also obtained data from the 2017 Ohio Medicaid Assessment Survey.
“According to data from 2016 to 2020, we saw the odds of a caretaker reporting a vision test decreased 10% each year,” Shelton said. “Lower household income made you less likely to report a vision test for a child.
“In the state of Ohio, less than 50% of Ohio’s kids had a vision exam in the last 12 months, and 76% have vision insurance,” she continued. “Those living below the federal poverty level were more likely to report having vision insurance. All Medicaid plans in Ohio have to include vision insurance benefits. Everyone living in that socioeconomic bracket should know they have insurance, but maybe there’s a caretaker gap.”
Eleven percent reported difficulty accessing vision care services, with those living below the poverty level having more difficulty.
“While vision insurance can be a barrier, socioeconomic status could be a bigger barrier,” Shelton said.
The study results showed that “poor correlations between exam completion for failed vision screenings and multiple social determinants suggest that comprehensive vision care is universally lacking in Ohio ... regardless of geography or socioeconomic status.”
The researchers said this data could be used for state programmatic planning to improve the link between children and comprehensive vision care. Such programs could include school-based clinic and mobile vision clinic initiatives.
Shelton said optometrists should work to influence necessary legislation at the state association level and also volunteer for programs.
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Shelton E, et al. Assessing vision screening as an intervention for addressing unmet vision care need in the pediatric population of Ohio. Presented at: Academy; Oct. 26-29, 2022; San Diego.
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