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Association of household language and vision screening among children in the United States
1Department of Ophthalmology, Rush University Medical College, Chicago, Illinois.
Insights
Children from non-English primary language households have lower vision testing rates. Interventions improving language services and health literacy are needed to increase pediatric vision screening.
Area of Science:
- Pediatric ophthalmology
- Public health
- Health disparities
Background:
- Annual vision testing is recommended for children aged 3+ to detect amblyopia.
- Vision testing rates in children from non-English primary language (NEPL) households are not well understood.
Observation:
- A national survey analyzed vision testing in 89,697 children aged 3-17.
- Overall, 70.9% of children received vision testing in the past year.
Findings:
- Children from NEPL households had lower vision testing rates (64.3% vs 72.0%).
- This disparity was linked to reduced testing in schools and by eye specialists, but increased testing at health clinics.
- Pediatrician testing rates were similar between groups.
Implications:
- Targeted interventions are needed to address vision screening disparities in NEPL households.
- Improving language services and health literacy can enhance access to timely vision care for all children.
Abstract:
The American Academy of Pediatrics recommends annual testing in children beginning at 3 years of age to detect vision problems and prevent amblyopia. However, rates of vision testing in children from non-English primary language (NEPL) households are not well delineated. This study analyzed the 2018-2020 National Survey of Children's Health to examine patterns and predictors of vision testing among children from NEPL households. In this nationally representative cohort of 89,697 children 3-17 years of age, 70.9% of children received vision testing during the previous 12 months. Children from non-English-speaking households were less likely to undergo vision testing (64.3% vs 72.0%; aOR [95% CI] = 0.83 [0.72-0.95], P = 0.008). Decreased vision testing among children from NEPL households was driven by lower rates of testing at school (16.1% vs 21.0%; 0.72 [0.57-0.89], P = 0.009) or from an ophthalmologist or optometrist (49.0% vs 54.0%; 0.72 [0.61-0.85], P = 0.0004), whereas children from NEPL households were more likely to receive vision testing at health clinics (14.4% vs 3.1%; 3.25 [2.40-4.39], P < 0.0001). No differences were observed in rates of testing by a pediatrician (41.1% vs 44.0%; 1.05 [0.89-1.23], P = 0.69). Interventions to improve language services and health literacy are warranted to increase rates of vision testing among children from NEPL households.
