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Racial and Ethnic Differences in Unmet Need for Vision Care among Children with Special Healthcare Needs
Archives of Ophthalmology
Heslin et al. examined racial/ethnic differences in unmet need
for vision care among 14,070 children in the National Survey of
Children with Special Healthcare Needs (CSHCN). Because CSHCN are
often unable to report what they can see during conventional eye
examinations, they may require more extensive and individually tailored
treatment of their vision than children without special needs. It is
critical to examine unmet need for vision care among CSHCN, because
poor access to vision care early in life places them at increased risk
of delays in long-term educational and social development.
The National Survey of CSHCN was a cross-sectional telephone survey
conducted by the National Center for Health Statistics between October
2000 and April 2002. A random-digit-dial sample of households
with children under 18 was selected from the 50 states and District of
Columbia. Respondents were adults who knew the most about the
child’s health. In this analysis, children who did not receive all the
eyeglasses or vision care they needed in the previous 12 months were
considered to have “unmet need for vision care.” Results showed that
six percent of children with special healthcare needs in the U.S. had
unmet need for vision care. Rates of unmet need ranged from 3% to
15% across the seven racial and ethnic groups studied. Compared
with whites, children of African American, Latino, and multiracial
backgrounds had approximately twice the adjusted risk of unmet need,
whereas American Indian/Alaskan Native children had lower adjusted
risk.
Healthcare providers, school personnel, insurance coverage, and other
factors also contributed to differences in the risk of unmet need,
independently of child race/ethnicity. Of particular policy
relevance is the finding that children covered by Medicaid or the State
Children’s Health Insurance Program (S-CHIP) had lower risk of unmet
need for vision care than did children with private insurance.
The authors conclude the study by noting that racial/ethnic differences
persisted even after accounting for school and healthcare provider
characteristics, which suggests that these resources should be
leveraged to increase the availability of vision care for all CSHCN.
