Research Assistant Professor University of Utah Salt Lake City, Utah, United States
Background: Children from immigrant vs non-immigrant households are more likely to have vision impairment. The American Academy of Pediatrics recommends vision testing throughout childhood to identify and treat vision impairment. Children from immigrant households may be less likely to receive this important screening even though they are more likely to have vision impairment. Objective: To determine if there is an association between children from an immigrant household and receipt of vision testing Design/Methods: De-identified, nationally representative data on children 3 to 17 years (n=49,442) were obtained from the 2018-2019 National Survey of Children’s Health. The primary exposure was immigrant generation (first generation: child and all reported parents were born outside the United States; second generation: child was born in the United States and at least one parent was born outside the United States; third or higher: all parents in the household were born in the United States). The outcomes were completion of vision testing during the past 12 months in various settings: primary care, eye doctor’s office, and any setting. Multivariable logistic regression models were fit to estimate odds (adjusted odds ratio; aOR) with 95% confidence intervals, controlling for key clinical and demographic variables and accounting for sampling weights. Unweighted frequencies and weighted percents were reported Results: 2,954 children (12.7%) were Black/African American, and 5,759 (25.5%) of Hispanic/Latino origin. 7,222 parents (27.6%) had at most a high school degree and 1,919 children (6.2%) no insurance. 916 (3.6%) were first generation, 7590 (24.2%) second generation and 40,315 (70.5%) third or higher generation. First generation children had lower odds of a vision test in a pediatrician/general doctor’s office (20.0%) (aOR 0.40; 95% CI 0.45, 0.82), eye doctor’s office (28.5%) (aOR 0.53; 95% CI 0.40, 0.72), and any setting (60.3%) (aOR 0.54; 95% CI 0.41, 0.71), than third or higher generation children (32.0% vs 40.7% vs 74.6% respectively). This association remained after excluding children without health coverage. For Hispanic children, both first generation (aOR 0.58; 95% CI 0.36, 0.94) and second-generation children (aOR 0.73; 95% CI 0.55, 0.96) had a lower odds of vision test in any setting compared with Hispanic children from third generation or higher households
Conclusion(s): Immigration generation is associated with access to vision testing for children. Qualitative studies are needed to understand the challenges faced by immigrant children in accessing vision care
