Socioeconomic Disparity in Use of Eye Care Services Among US Adults With Age-Related Eye Diseases

Abstract

Individuals with age-related eye disease (ARED) need to use eye care services for detection, assessment, and care at regular intervals. OBJECTIVE To explore the association between socioeconomic position (SEP) and use of eye care services among US adults with self-reported ARED during 2002 and 2008. DESIGN Data were from the National Health Interview Survey 2002 and 2008. We used multiple logistic regression to estimate predictive margins, controlling for other factors, and we used the slope index of inequality to measure the relationship between SEP and use of eye care services across the entire distributions of poverty-income ratio (PIR) and educational attainment. SETTING A cross-sectional, nationally representative sample of adults, with prevalence estimates weighted to represent the civilian, noninstitutionalized US population. PARTICIPANTS The sample included US participants in the 2002 (n = 3586) and the 2008 (n = 3104) National Health Interview Survey who were at least 40 years old and reported any ARED (age-related macular degeneration, cataract, diabetic retinopathy, or glaucoma). MAIN OUTCOMES AND MEASURES Use of eye care services; SEP was measured by the PIR and educational attainment. RESULTSIn 2002, persons with ARED and a PIR of less than 1.50 were significantly less likely than those with a PIR of at least 5 to report visiting an eye care provider (62.7% vs 80.1%; P < .001) or undergoing a dilated eye examination in the past 12 months (64.3% vs 80.4%; P < .001), after adjustment for other factors. Similarly, persons with less than a high school education were less likely than those with at least a college education to report a visit to an eye care provider (62.9% vs 80.8%; P < .001) or dilated eye examination (64.8% vs 81.4%; P < .001). In 2002, the slope index of inequality showed statistically significant differences for eye care provider visits across the levels of education (24.4; P = .006), and in 2008, it showed a significant difference for eye care provider visits across the levels of educational attainment (25.2; P = .049) and PIR (21.8; P = .01).CONCLUSIONS AND RELEVANCE Significant differences in the use of eye care services by SEP persist among US adults with eye diseases.

Nonmedical Out-of-Pocket Patient and Companion Expenditures Associated With Glaucoma Care

“…As the study was done in 3 clinics in 2 clinical practice settings in the mid-Atlantic region, it may not be representative of the entire United States, but we observe that the diversity in practice location provides a patient population from urban, suburban, and rural areas. Whereas study respondents had a higher level of education 19 and were more likely to be African American than the United States glaucoma pop- ulation, 20 neither race nor education was a significant predictor of cost in our study.…”

Variations and Trends in Health Burden of Visual Impairment Due to Cataract: A Global Analysis

“…Even in the United States, annual use of eye services was significantly associated with levels of educational attainment after adjusting for other factors. [32][33][34] A randomized controlled trial demonstrated that educational interventions can successfully increase the uptake of cataract surgery. 35 Sex differences in the health burden of cataract vision loss were significant for each age group.…”

Trends of barriers to eye care among adults with diagnosed diabetes in Germany, 1997–2012

“…In particular, men, those who are living alone, persons with lower socioeeconomic position and without current employment experienced the strongest decline. These findings are worrisome, given the fact that men and individuals with lower educational attainment, fewer financial resources and without a job also showed a steeper increase of type 2 diabetes over past two decades in Germany [1], have a higher risk of diabetes-related sequels [45,46], and lower quality of diabetes management [44,47]. Diabetes-related eye disease is particularly problematic in those with undiagnosed diabetes and the problem of underdiagnosis is greater within socioeconomically deprived subjects [48].…”