Socioeconomic Status and Vision Care Services in Ontario, Canada: A Population-Based Cohort Study.

Objective To test the association of material deprivation and the utilization of vision care services for young children. Study design We conducted a population-based, repeated measures cohort study using linked health and administrative datasets. All children born in Ontario in 2010 eligible for provincial health insurance were followed from birth until their 7th birthday. The main exposure was neighborhood-level material deprivation quintile, a proxy for socioeconomic status. The primary outcome was receipt of a comprehensive eye examination (not to include a vision screening) by age 7 years from an eye care professional, or family physician. Results Of 128,091 children included, females represented 48.7% of the cohort, with 74.4% living in major urban areas and 16.2% living in families receiving income assistance. Only 65% (n=82,833) had at least one comprehensive eye examination, with the lowest uptake (56.9%; n= 31,911) in the most deprived and the highest uptake (70.5%; n =19,860) in the least deprived quintiles. After adjusting for clinical and demographic variables, children living in the least materially deprived quintile had a higher odds of receiving a comprehensive eye examination (aOR 1.43; 95%CI 1.36, 1.51) compared with children in the most material deprived areas. Conclusions Uptake of comprehensive eye examinations is poor, especially for children living in the most materially deprived neighbourhoods. Strategies to improve uptake and reduce inequities are warranted.