Children from marginalized racial, ethnic groups less likely to receive preventive eye care
Key takeaways:
- Of 30,173 children included, 18,494 underwent vision screening within the last 2 years.
- Children from historically marginalized groups, low-income households and non-English language speakers had worse outcomes.
Children from historically marginalized racial and ethnic groups and low-income households were less likely to receive vision screening and establish care with a specialist, according to a research letter published in JAMA Ophthalmology.
“Vision screening is a fundamental component of preventive health care delivered to children worldwide,” Isdin Oke, MD, MPH, from the department of ophthalmology at Boston Children’s Hospital and Harvard Medical School, and colleagues wrote. “In the U.S., children may receive vision screening in multiple settings, including primary care clinics, schools and community events. However, the multifaceted approach and variability in vision screening policies may result in missed care for children with preventable vision loss.”
In a cross-sectional study of deidentified data from the 2021 National Survey of Children’s Health, researchers analyzed receipt of screening, referral for eye exam and establishment of specialty care among children aged 6 to 18 years.
Among sociodemographic factors included the survey were age, sex, race and ethnicity, insurance type, household income, caregiver education level, household generation and primary household language.
Of 30,173 children included, 18,494 underwent vision screening within the last 2 years, and 5,134 of those screened were referred for an eye exam. Among those referred, 4,823 reported establishing care with a specialist.
Results also showed that children identifying as Hispanic, non-Hispanic Asian or non-Hispanic Black, residing in low-income households and with non-English primary language speakers were less likely to receive screening and specialist care, but more likely to be referred for an eye exam. Similarly, adolescents, children without health insurance and children whose caregivers had less than a high school education were less likely to receive screening and more likely to be referred for an eye exam.
“High referral rates in these vulnerable groups may suggest higher prevalence of undiagnosed conditions or elevated false-positive results from suboptimal screening strategies,” Oke and colleagues wrote. “The cumulative effect of each step along the pathway may contribute to the racial, ethnic and socioeconomic disparities in visual outcomes that are already evident by adolescence.”
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