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Association Between Neighborhood Opportunity Levels and Requiring Retinopathy of Prematurity Treatment
Akshara R Legala1, Shira L Robbins2, Eric Nudleman2
1University of California San Diego School of Medicine.
Insights
Neighborhood socioeconomic status is linked to retinopathy of prematurity (ROP) treatment needs. Lower socioeconomic status areas show higher ROP treatment requirements, highlighting the role of social determinants in eye care disparities.
Area of Science:
- Ophthalmology
- Public Health
- Socioeconomic Determinants of Health
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Understanding the influence of socioeconomic factors on ROP treatment is crucial for addressing health disparities.
Purpose of the Study:
- To investigate the association between neighborhood-level socioeconomic status, measured by the Child Opportunity Index (COI), and the need for retinopathy of prematurity (ROP) treatment.
- To explore how socioeconomic factors contribute to disparities in ROP management.
Main Methods:
- Retrospective review of electronic medical records for patients treated for ROP from January 2010 to March 2024.
- Matched control group of pediatric ophthalmology patients without a history of ROP.
- Utilized the Child Opportunity Index (COI) based on patient ZIP codes to assess neighborhood socioeconomic status.
Main Results:
- Patients requiring ROP treatment had significantly lower mean COI scores compared to controls (48 vs. 56, P < .001).
- The ROP group exhibited a higher proportion of Hispanic/Latino patients (51.8% vs. 41.9%, P = .01).
- Type 1 ROP patients showed lower mean COI scores and a higher prevalence of Medi-Cal insurance compared to controls.
Conclusions:
- Neighborhood socioeconomic status is a critical factor in the management and treatment requirements of retinopathy of prematurity.
- Social determinants of health, including socioeconomic status, play a synergistic role in ROP disparities.
- Findings underscore the need for community-level interventions to address health disparities in ROP care.
Purpose:
To determine the relationship between neighborhood-level socioeconomic status and requiring retinopathy of prematurity (ROP) treatment, using the Child Opportunity Index (COI).
Methods:
Electronic medical records for all patients who received ROP treatment from January 2010 to March 2024 at a tertiary care center were retrospectively reviewed. Controls were obtained by matching pediatric ophthalmology patients with the closest clinic visit date and no history of retinopathy of prematurity. Demographic and clinical information were collected. The patient's 5-digit ZIP code was used to determine the COI score and level.
Results:
This study included 245 study patients and 735 matched controls, of which 110 (44.9%) and 329 (44.8%) were female, respectively. The study group had a significantly lower mean COI score (48 ± 29) compared to controls (56 ± 31, P < .001). Additionally, the study group had a higher percentage of Hispanic/Latino patients compared to the control group (51.8% vs 41.9%, respectively, P = .01). When stratified into type 1 (n = 195) and type 2 (n = 50) ROP, patients in the ROP groups continued to have lower mean COI scores (50 ± 29 and 44 ± 28, respectively) than the control group (56 ± 31; P = .01 and P = .006, respectively). The type 1 ROP group had a greater number of patients with Medi-Cal insurance compared to the control group (50.8% vs 46.4%, respectively, P = .04).
Conclusions:
Neighborhood socioeconomic status may play a critical role in the management of ROP. It is important to understand the synergistic relationship between social determinants of health when addressing health disparities and developing community-level interventions.
