Abstract
Purpose: :
To explore the association between socioeconomic position (SEP) and access to eye care services among US adults with age-related eye diseases (ARED) during 2002 and 2008.
Methods: :
We analyzed US participants aged ≥ 40 years who reported any ARED (cataract, diabetic retinopathy, glaucoma, age-related macular degeneration) in 2002 (n=3586) and 2008 (n=3104) National Health Interview Survey. SEP was measured by the poverty-income-ratio (PIR) in quartiles and education attainment. We used multiple logistic regression analysis to estimate predictive margins, controlling for age and sex. We measured the linear relationship between SEP and access to eye care services across the entire distributions of PIR and education using the slope index of inequality (SII).
Results: :
In 2002 the predicted probabilities of eye doctor visit or dilated eye examination did not differ significantly by SEP. However, in 2008, persons with PIR <1 were significantly less likely than those with PIR ≥5 to visit an eye doctor (61.5% vs. 78.2%; P <0.001) or have a dilated eye examination (79.1% vs. 91.7%; P <0.001). A similar pattern was seen for education < high school vs. education ≥ college (59.9% vs. 78.1%; P<0.001 for eye doctor visit and 80.4% vs. 98.2%; P<0.001 for dilated eye examination). The SII showed no statistically significant differences across the levels of income or education in 2002. However, in 2008, the SII showed a significant difference for eye doctor visit and dilated eye examination across the levels of PIR and education attainment (P<0.01).
Conclusions: :
In contrast to 2002, significant SEP difference in access to eye care services among adults with ARED emerged by 2008. Appropriate and timely public health interventions providing needed eye care services to reduce this emerging disparity are desirable.
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: prevalence/incidence • clinical (human) or epidemiologic studies: risk factor assessment