Eye care in the United States: do we deliver to high-risk people who can benefit most from it?
OBJECTIVE
To estimate the levels of self-reported access of eye care services in the nation.


METHODS
We analyzed data from the 2002 National Health Interview Survey (30 920 adults aged > or =18 years). We estimated the number of US adults at high risk for serious vision loss and assessed factors associated with the use of eye care services.


RESULTS
An estimated 61 million adults in the United States were at high risk for serious vision loss (they had diabetes, had vision or eye problems, or were aged > or =65 years); 42.0% of the 78 million adults who had dilated eye examinations in the past 12 months were among this group. Among the high-risk population, the probability of having a dilated eye examination increased with age, education, and income (P<.01). The probability of receiving an examination was higher for the insured, women, persons with diabetes, and those with vision or eye problems (P<.01). Approximately 5 million high-risk adults could not afford eyeglasses when needed; being female, having low income, not having insurance, and having vision or eye problems were each associated with such inability (P<.01).


CONCLUSIONS
There is substantial inequity in access to eye care in the United States. Better targeting of resources and efforts toward people at high risk may help reduce these disparities.
Zhang
Xinzhi
X
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE (K-10), Atlanta, GA 30341-3727, USA. xzhang4@cdc.gov
Saaddine
Jinan B
JB
Lee
Paul P
PP
Grabowski
David C
DC
Kanjilal
Sanjat
S
Duenas
Michael R
MR
Narayan
K M Venkat
KM
D000293:Adolescent; D000328:Adult; D000368:Aged; D005128:Eye Diseases / Q000628:therapy*; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D014481:United States