title: Government-insured routine eye examinations and prevalence of nonrefractive vision problems among elderly.
abstract: OBJECTIVE
  To assess whether lack of government-insured annual routine eye examinations was associated with reduced vision health status among elderly Canadians.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Respondents aged ≥ 65 years in the Canadian Community Health Survey 2000-2001.
  
  
  METHODS
  The prevalence of nonrefractive vision problems (i.e., unable to see close or distance when wearing glasses or contact lenses) between Canadians with and without government-insured annual eye examinations was compared.
  
  
  RESULTS
  Uninsured white individuals had a greater prevalence rate of vision problems (8.5%; 95% CI 6.8-10.2) than insured white individuals (6.4%; 95% CI 5.2-7.6) if their household incomes were less than the midlevel. In those with household incomes at the midlevel or higher, the prevalence rate was similar between the insured (4.3%) and uninsured (3.6%; p>0.05). Compared with elderly adults in the mid- to high-income level and living in insured provinces, white elderly adults residing in provinces with no insurance had 50% higher odds of reporting vision problems (adjusted odds ratio [OR] 1.5; 95% CI 1.1-2.0) if their income was less than the midlevel, but a 30% lower likelihood of having vision problems if their income was in the midlevel or higher (adjusted OR 0.7; 95% CI 0.6-1.0). The mean age at diagnosis of glaucoma and cataracts was about 2 years older for uninsured versus insured white individuals. Analyses among non-white individuals were not permitted because of small sample size.
  
  
  CONCLUSIONS
  Lack of government-funded annual routine eye examinations is associated with increased levels of nonrefractive vision problems among low-income elderly adults.
authors.affiliation: Department of Ophthalmology and Vision Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, ON. yaping.jin@utoronto.ca
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Jin
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Buys
authors.forename: Juan
authors.initials: J
authors.lastname: Xiong
authors.forename: Graham E
authors.initials: GE
authors.lastname: Trope
mesh_terms: D000368:Aged; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000453:epidemiology*; D006078:Government Programs; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006306:Health Surveys; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D009313:National Health Programs; D010808:Physical Examination; D015995:Prevalence; D012923:Social Class; D015351:Vision Screening; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*