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Are there inequities in the utilization of childhood eye care services in relation to socioeconomic status? Evidence from the ALSPAC cohort.
  1. Muzakir Majeed (muzakir{at}doctors.org.uk),
  2. Cathy Williams (cathy.williams{at}bristol.ac.uk),
  3. Yoav Ben-Shlomo (y.ben-shlomo{at}bristol.ac.uk)
  1. Dept of Social Medicine, University of Bristol, United Kingdom
  2. Bristol Eye Hospital and Centre for Child and Adolescent Health, University of Bristol, United Kingdom
  3. Dept of Social Medicine, University of Bristol, United Kingdom

    Abstract

    Background: Equity of access to eye care in childhood remains poorly researched and most studies report data on utilization 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 who 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 to social class I, the prevalence of eye disease was higher in the lower groups (social class IIIM, IV, V) (odds ratio 1.69, 95% CI 1.15-2.46). However, children from lower socioeconomic status groups were less likely to see an eye care specialist (odds ratio 0.83, 95% CI 0.70-1.00) or to use screening services (OR 0.65, 95% CI 0.43-0.98).

    Discussion/Conclusion: The differences in the trends between socioeconomic groups in eye conditions and utilization of services suggest inequitable access to services. Our data highlight the limitations of community-based pre-school 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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