Are there inequities in the utilisation of childhood eye-care services in relation to socio-economic status? Evidence from the ALSPAC cohort.

Full Abstract

BACKGROUND:
Equity of access to eye care in childhood remains poorly researched, and most studies report data on utilisation without any objective measure of clinical need. Participants/method:
8271 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), a longitudinal birth cohort, were seen at age 7, when they underwent a comprehensive eye examination and details of family history of eye conditions, vision problems and contact with eye-care services were obtained.

RESULTS:
2931 (35.4%) children had been in contact with an eye-care specialist, and 1452 (17.6%) had received vision screening. Compared with social class I, the prevalence of eye conditions was higher in the lower groups (social class IIIM, IV, V) (OR 1.69, 95% CI 1.15 to 2.46). However, children from lower socio-economic status groups were less likely to see an eye-care specialist (OR 0.83, 95% CI 0.70 to 1.00) or to use screening services (OR 0.65, 95% CI 0.43 to 0.98).

DISCUSSION/CONCLUSION:
The differences in the trends between socio-economic groups in eye conditions and utilisation of services suggest inequitable access to services. These data highlight the limitations of community-based preschool vision screening, which fails to abolish this inequity. It is important that future research explores the reasons behind these patterns. Compulsory school-entry vision screening, as recommended by the National Screening Committee and the Hall Report may redress this differential uptake of services.

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Author information

Author/s: Majeed, M (M); Williams, C (C); Northstone, K (K); Ben-Shlomo, Y (Y);

Affiliation: Department of Social Medicine, Canynge Hall, Bristol, UK.

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The British journal of ophthalmology (Br J Ophthalmol), published in England. (Language: eng)

Reference: 2008-Jul; vol 92 (issue 7) : pp 965-9

Dates: Created 2008/06/25; Completed 2008/08/04;

PMID: 18480307, status: MEDLINE (last retrieval date: 11/6/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Child
Child Health Services - utilization
England - epidemiology
Epidemiologic Methods
Female
Health Services Research - methods
Humans

Male
Needs Assessment
Ophthalmology - organization & administration; statistics & numerical data
Patient Acceptance of Health Care - statistics & numerical data
Social Class
Vision Disorders - diagnosis; epidemiology; therapy
Vision Screening - utilization

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