Purchase this article with an account.
R.S. Baker, K.C. Heslin, M. Shaheen, R. Casey; Racial and Ethnic Disparities in Access to Vision Care Among Children With Special Health Care Needs in the United States . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1166.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: All children should receive periodic vision screening and, if indicated, vision care services to address impaired functioning. The purpose of this study was to examine racial and ethnic disparities in access to vision care using secondary survey data on a representative sample of 14,070 children with special health care needs (CSHCN) in the United States. Methods: The National Survey of Children with Special Health Care Needs was a cross–sectional survey conducted from October 2000 to April 2002. A random–digit–dial sample of households with children under age 18 was selected from the 50 states and the District of Columbia. Respondents were parents or guardians who knew the most about the index child’s health. Unmet need for vision care was assessed by asking, "During the past 12 months, was there any time your child needed eyeglasses or vision care?" and then: "Did your child receive all the eyeglasses or vision care that he or she needed?" If the respondent answered "yes" to the first question and "no" to the second, the child was categorized as having unmet need for vision care. We used multivariate logistic regression to estimate the independent association of race and ethnicity with unmet need. Control variables included child gender, age, disability status, insurance coverage, illness severity, mother’s educational achievement, cultural competence of the child's primary care physician (as perceived by the respondent), and a count variable of unmet needs for other types of health services that ranged from 0 to 13. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The Stata software program was used to estimate population prevalence parameters and, in the multivariate analysis, to adjust standard errors for the complex survey sampling design. Results: Of the estimated 3,321,870 CSHCN represented in this analysis, 6% had unmet need for vision care. Approximately 5% of whites had unmet need, compared with 9% of African Americans, 10% of Latinos, 14% of multiracial children, and 8% of children of "other" racial and ethnic backgrounds (p<0.0001). Multivariate analysis showed that, compared with whites, African Americans had twice the odds (OR = 2.01; 95% CI = 1.37, 2.96) and children of multiracial backgrounds had three times the odds (OR = 3.06; 95% CI = 1.62, 5.75) of having unmet need for vision care. Latino children and those of "other" racial and ethnic backgrounds did not differ from whites in the multivariate analysis. Conclusions: Outreach programs should target CSHCN in underserved racial and ethnic minority communities to reduce disparities in access to vision care.
This PDF is available to Subscribers Only