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Updated 11:00 AM March 8, 2004



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Minority and uninsured children far less likely
to get eye exams or glasses

A quartet of studies focusing on children's eye care finds that race, income, location, gender and insurance status can make a big difference in the likelihood that children with vision problems will see an eye specialist or get lenses to correct their vision.

Minority children, and those whose parents don't have insurance, are least likely to receive such care, while white girls are mostly likely to receive it.

And while state-sponsored, school-based eye exams appear to spot vision problems effectively, the follow-up varies for children who can't see clearly.
A major source of this disparity appears to be the amount of cash that parents have to spend.

These conclusions, from a study published in the March issue of the journal Pediatrics, and from three other studies published recently in major journals, come from a team of pediatric researchers at the U-M Health System. Noting the lack of solid data on children's eye care, they decided to examine the way kids' vision problems are detected and corrected.

Using state and national databases, interviews with parents and public health providers, and information about the location of optometrists and ophthalmologists, the researchers for the first time are bringing into focus some major underlying disparities in children's eye care.

In the Pediatrics study, non-Hispanic white Michigan children enrolled in Medicaid were 37 percent more likely than Hispanic or non-white children to visit an eye specialist or be prescribed corrective lenses in a one-year period.

In a study published in the January issue of Optometry and Vision Sciences, uninsured black and Hispanic children had far lower odds of having eyeglasses or contact lenses than other children, regardless of insurance status—and Black children without insurance were least likely of all to receive vision correction.

A major source of this disparity appears to be the amount of cash that parents have to spend to take care of their children's eyes, according to Dr. Alex Kemper, lead author on all four papers and an assistant professor of pediatrics at the Medical School, and his colleagues in the Child Health Evaluation and Research Unit of the Division of General Pediatrics.

"Routine vision care is largely an out-of-pocket expense in this country—except for children enrolled in Medicaid—and it can be expensive. Even when insurance covers some expenses, parents find themselves paying for glasses that their children like better than the covered ones, or for replacements when glasses break or contact lenses get lost," he says.

Kemper and his colleagues published the results of an exhaustive examination of Michigan's vision screening program in the February American Journal of Preventive Medicine. The team also published the results of an analysis of data from the National Health Interview Study in the September/October issue of Ambulatory Pediatrics.

Funding for the four studies came from the National Eye Institute of the National Institutes of Health, the Michigan Department of Community Health, and Kemper's previous support as a Pfizer Scholar.

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