title: Are there inequities in the utilisation of childhood eye-care services in relation to socio-economic status? Evidence from the ALSPAC cohort.
abstract: BACKGROUND
  Equity of access to eye care in childhood remains poorly researched, and most studies report data on utilisation without any objective measure of clinical need. Participants/method: 8271 participants from the Avon Longitudinal Study of Parents and Children (ALSPAC), a longitudinal birth cohort, were seen at age 7, when they underwent a comprehensive eye examination and details of family history of eye conditions, vision problems and contact with eye-care services were obtained.
  
  
  RESULTS
  2931 (35.4%) children had been in contact with an eye-care specialist, and 1452 (17.6%) had received vision screening. Compared with social class I, the prevalence of eye conditions was higher in the lower groups (social class IIIM, IV, V) (OR 1.69, 95% CI 1.15 to 2.46). However, children from lower socio-economic status groups were less likely to see an eye-care specialist (OR 0.83, 95% CI 0.70 to 1.00) or to use screening services (OR 0.65, 95% CI 0.43 to 0.98).
  
  
  CONCLUSIONS
  The differences in the trends between socio-economic groups in eye conditions and utilisation of services suggest inequitable access to services. These data highlight the limitations of community-based preschool vision screening, which fails to abolish this inequity. It is important that future research explores the reasons behind these patterns. Compulsory school-entry vision screening, as recommended by the National Screening Committee and the Hall Report may redress this differential uptake of services.
authors.affiliation: Department of Social Medicine, Canynge Hall, Bristol, UK.
authors.forename: M
authors.initials: M
authors.lastname: Majeed
authors.forename: C
authors.initials: C
authors.lastname: Williams
authors.forename: K
authors.initials: K
authors.lastname: Northstone
authors.forename: Y
authors.initials: Y
authors.lastname: Ben-Shlomo
mesh_terms: D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009885:Ophthalmology / Q000458:organization & administration* / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012923:Social Class; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015351:Vision Screening / Q000706:statistics & numerical data