Several sociodemographic factors are associated with poor vision in children under 18, including non-white ethnicity, family status, education level, access to insurance and more. Photo: Getty Images.

In a new study, researchers sought to determine sociodemographic predictors of poor vision in children and found several, including being unable to afford medical care and having public health insurance, with children ranging from ages five to eight having higher odds in vision difficulty.

Using data from the 2021 National Health Interview Survey (NHIS), 8,261 children—7,373 of which had data pertaining to vision difficulty—were included. Sociodemographic variables were investigated as predictors of vision difficulty.

Poor vision was associated with being unable to afford medical care and having public health insurance. Compared to children under age five, children ranging from ages five to eight had a higher odds of vision difficulty.

“Expectations for vision are likely to increase as children become older, given they may have more complex and significant visual needs with age, especially when transitioning into school,” the authors explained in their article for American Journal of Ophthalmology. “Hence, it is plausible that there may be a greater detection, and in turn reporting of vision difficulties among older children by their caregivers, although further research is warranted to better understand the mechanisms contributing to an increasing odds of vision difficulty with age in children.”

Compared to children for whom the highest level of education of adults in their family was grade one through 11, the odds of vision difficulty were lower in children whose parents had a professional school or doctoral degree.

The following sociodemographic factors were found to be potential predictors of vision difficulty in children: increasing age, living in a rented residence or with an unmarried parent, being situated in the South, West, or Midwest of the United States, having public insurance coverage, being unable to afford medical care, lacking basic needs, receiving income from public assistance and being deprived of food security.

But the following factors were significantly associated with vision difficulty in children: being unable to afford medical care and having public health insurance.

The odds of vision difficulty were greater for children living in a household with only Hispanic or Black/African American persons when compared to households with non-Hispanic white individuals.

“Racial differences in vision health are especially apparent when scrutinizing the disproportionate burden of treatable eye diseases affecting underserved adult populations, which is often as a result of inequities in utilization and access of health care,” the authors explained in their paper. “In working towards achieving equity in vision health, it is imperative that disparities mediated by sociodemographic factors are addressed through public health policies.”

Mihalache A, Huang RS, Patil NS, et al. Association between vision difficulty and sociodemographic factors in children: a population-based analysis. Amer J Ophthalmol. October 1, 2023. [Epub ahead of print.]