June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Association of Primary Household Language and Vision Testing Among US Children from 2016-2020
Author Affiliations & Notes
  • Sayuri Sekimitsu
    Tufts University School of Medicine, Boston, Massachusetts, United States
  • Megan E Collins
    Johns Hopkins University, Baltimore, Maryland, United States
  • Nazlee Zebardast
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Sayuri Sekimitsu None; Megan Collins None; Nazlee Zebardast None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1410. doi:
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      Sayuri Sekimitsu, Megan E Collins, Nazlee Zebardast; Association of Primary Household Language and Vision Testing Among US Children from 2016-2020. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1410.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Eight-point-seven percent of the US population is estimated to have limited English proficiency (LEP). Previous research has shown LEP patients receive preventive care less often that patients of a similar ethnicity who speak English and have higher rates of emergency surgeries and cancer found at advanced stages. For children, vision screening between ages 3-5 and subsequent repeat testing every 1-2 years is recommended by several national organizations. Here we investigate the association between primary household language and vision testing among children living in the US from 2016 to 2020.

Methods : This analysis utilized data for children aged 0-17 from the National Survey of Children’s Health (NSCH) from 2016-2020 to obtain prevalence of vision testing by primary household language and race/ethnicity. Primary household language and vision testing were determined by survey responses. Complex samples logistic regression models, adjusted for insurance coverage, income, race/ethnicity, highest level of education of adult in household, and year, were developed to determine the likelihood of vision testing.

Results : Amongst the 173,097 NSCH respondents from 2016-2020, 11,539 (6.67%) were from non-English-speaking households. Vision testing was higher among children from English-speaking households, compared to non-English speaking households (66.8% vs. 59.5%, p<0.001). Among children of all ages, children from non-English-speaking households were 20% less likely to receive vision testing (adjusted OR (aOR) = 0.80, 95% CI 0.72-0.89, p<0.001). Among children ages 3-5, children from non-English-speaking households were 32% less likely to receive vision testing (aOR = 0.68, 95% CI 0.54-0.87, p=0.002). Among all race/ethnicity groups, individuals from non-English speaking households had lower rates of vision testing compared to English-speaking households (Figure 1). This difference in vision testing was statistically significant (p<0.001) in all groups, except those of Hispanic ethnicity (p=0.067). This trend remained consistent in multivariate regression models (Figure 2).

Conclusions : In this nationally representative sample, children from non-English speaking households are less likely to receive vision testing compared to children from English-speaking households, highlighting a need to improve language services, health literacy, and connection to vision services in this population.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.




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