Access to vision care for children from immigrant and nonimmigrant households: evidence from the National Survey of Children's Health 2018-2019.
Afua O Asare, Brian C Stagg, Carole Stipelman, Heather T Keenan, Melissa Watt, Guilherme Del Fiol, Marielle P Young, Justin D Smith
Author Information
Afua O Asare: John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah; Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah. Electronic address: afua.asare@utah.edu.
Brian C Stagg: John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah; Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah.
Carole Stipelman: Department of Pediatrics, Division of General Pediatrics, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah.
Heather T Keenan: Department of Pediatrics, Division of General Pediatrics, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah.
Melissa Watt: Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah.
Guilherme Del Fiol: Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah.
Marielle P Young: John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah.
Justin D Smith: Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah.
PURPOSE: To investigate whether immigrant generation is associated with caregiver-reported receipt of vision testing. METHODS: Nationally representative data from the 2018-2019 National Survey of Children's Health was used. The primary exposure was immigrant generation, with first generation defined as child and all reported parents born outside the United States; second generation, as child born in the United States but at least one parent born outside the United States; and third generation, as all parents in the household born in the United States. The main outcome was caregiver-reported vision testing during the previous 12 months. Odds ratios adjusted for sociodemographic characteristics and 95% confidence intervals were computed based on immigrant generation. RESULTS: The sample included 49,442 US children 3-17 years of age. The proportion of children who had vision testing in any setting was lower for first- (60.3%) than third-generation children (74.6%; aOR = 0.54; 95% CI, 0.41-0.71). This association remained after excluding children without health coverage. For Hispanic children, both first- (aOR = 0.58; 95% CI, 0.36-0.94) and second-generation children (aOR = 0.73; 95% CI, 0.55-0.96) had lower odds of a vision test in any setting compared with third-generation Hispanic children. CONCLUSIONS: First-generation children had lower odds of vision testing than third-generation children, even when adjusting for sociodemographic characteristics, especially in Hispanic households.
