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Controversies in ophthalmology
Socioeconomic status and blindness
  1. Rakhi Dandonaa,b,c,
  2. Lalit Dandonaa,b
  1. aInternational Centre for Advancement of Rural Eye Care, LV Prasad Eye Institute, Hyderabad, India, bCentre for Social Services Administrative Staff College of India, Hyderabad, India, cCentre for Eye Research Australia, University of Melbourne, Melbourne, Australia
  1. Dr Rakhi Dandona, Administrative Staff College of India, Bella vista, Raj Bhavan Road, Hyderabad—500 082, Indiarakhi{at}asci.org.in

https://doi.org/10.1136/bjo.85.12.1484

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    Reference to inequalities in health has been made in the past—for example, by William Farr in the 19th century.1Although significant improvements in health have taken place in many parts of the world over the last century, major inequalities in health continue to persist among various population groups.2 3The socioeconomically disadvantaged regions of the world experience higher mortality and disability rates, which are the highest in sub-Saharan Africa and lowest in the established market economies.4 There is evidence that these inequalities also exist within the developed countries5-7 as well as within the developing countries.8 9

    Globally there is increasing concern for the health of the poor and for reduction in health inequalities.2 3 Inequalities refer to relative health status. In simple terms, this is a measure of how worse off the disadvantaged group is relative to the advantaged group.2 Health inequalities can be assessed by two different aspects of health—the health status and the health service use and financing.3 The traditional approach for assessing inequalities in health status has been based on income or economic standing. In addition, education and occupation have also been used to assess the differences in health status as a proxy for economic status. However, the economic dimension is not the only one that influences health inequalities. The other important dimensions are sex, ethnic, and regional inequalities. The other aspects of health inequalities, health service use and financing, measure the inequality in the use of and spending on health services between various population groups.

    This review presents a summary of the data available regarding inequalities in the prevalence and causes of blindness between various socioeconomic groups. A literature review was carried out for surveys published in 1990 or later to assess the following: (i) variations in the …

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