Are there inequities in the utilisation of childhood eye-care services in relation to socio-economic status? Evidence from the ALSPAC cohort. Issue 7 (14th May 2008)

• Record Type: Journal Article
• Authors: Majeed, M; Williams, C; Northstone, K; Ben-Shlomo, Y
• Is Part Of: British journal of ophthalmology. Volume 92:Issue 7(2008)
• Page Start: 965
• Page End: 969
• Publication Date: 2008-05-14
• Subjects: Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjo.2007.134841
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Background: Equity of access to eye care in childhood remains poorly researched, and most studies report data on utilisation without any objective measure of clinical need. Participants/method: 8271 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), a longitudinal birth cohort, were seen at age 7, when they underwent a comprehensive eye examination and details of family history of eye conditions, vision problems and contact with eye-care services were obtained. Results: 2931 (35.4%) children had been in contact with an eye-care specialist, and 1452 (17.6%) had received vision screening. Compared with social class I, the prevalence of eye conditions was higher in the lower groups (social class IIIM, IV, V) (OR 1.69, 95% CI 1.15 to 2.46). However, children from lower socio-economic status groups were less likely to see an eye-care specialist (OR 0.83, 95% CI 0.70 to 1.00) or to use screening services (OR 0.65, 95% CI 0.43 to 0.98). Discussion/conclusion: The differences in the trends between socio-economic groups in eye conditions and utilisation of services suggest inequitable access to services. These data highlight the limitations of community-based preschool vision screening, which fails to abolish this inequity. It is important that future research explores the reasons behind these patterns. Compulsory school-entry vision screening, as recommended by the National Screening Committee and the Hall Report may redress this differential uptake of services.