Do immigrants underutilize optometry services?

Fernando Wilson, Yang Wang, Jim P. Stimpson

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose. To characterize utilization of office-based optometry services by immigration status using a nationally representative database. Methods. The 2007 to 2011 Medical Expenditure Panel Survey is used to examine adults aged 18 years and older. Respondents were classified as US natives, naturalized citizens, and noncitizens. Multivariate logistic regression analysis examined the relationship of having visited an office-based optometrist within the past 12 months by immigrant status, adjusting for age, sex, education, race/ethnicity, marital status, self-reported vision difficulty, use of corrective lenses, poverty status, insurance, language barrier and usual source of care. Oaxaca-Blinder decomposition identified factors that perpetuate or ameliorate disparities in utilization across immigrant groups. Results. The proportion of US natives who had visited an optometrist within the past year was 7.2%, almost three times higher than that for noncitizens (2.5%). Among respondents who reported vision difficulties, only 47.9%of noncitizens used corrective lenses compared with 71.0% of naturalized citizens and 71.6%of US natives. Adjusting for confounding factors, multivariate logistic regression showed that naturalized citizens and noncitizen residents had significantly lower odds than US natives of receiving optometry services (naturalized citizen adjusted odds ratio, 0.77; 95% confidence interval, 0.66 to 0.89; noncitizen adjusted odds ratio, 0.44; 95% confidence interval, 0.36 to 0.53). Decomposition analysis suggested that 17% of the disparity in utilization between noncitizens and US natives resulted from barriers to care such as language barriers, poverty, lack of insurance, and not having a usual source of health care. Conclusions. Prior literature suggests that immigrants have significantly poorer clinical vision outcomes than US natives. Our findings suggest that this disparity in clinical vision outcomes may result from underutilization of optometry services by immigrants compared with US natives. Immigrant patients may need targeted interventions that reduce barriers to care and change their perceptions so that regular eye care services are viewed as necessary and preventative.

Original languageEnglish (US)
Pages (from-to)1113-1119
Number of pages7
JournalOptometry and Vision Science
Volume92
Issue number11
DOIs
StatePublished - Oct 27 2015

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Optometry
Population Groups
Communication Barriers
Poverty
Lenses
Logistic Models
Odds Ratio
Confidence Intervals
Insurance Coverage
Sex Education
Emigration and Immigration
Marital Status
Health Expenditures
Insurance
Regression Analysis
Databases
Delivery of Health Care

Keywords

  • Health care disparity
  • Immigrants
  • Optometry

ASJC Scopus subject areas

  • Ophthalmology
  • Optometry

Cite this

Do immigrants underutilize optometry services? / Wilson, Fernando; Wang, Yang; Stimpson, Jim P.

In: Optometry and Vision Science, Vol. 92, No. 11, 27.10.2015, p. 1113-1119.

Research output: Contribution to journalArticle

Wilson, Fernando ; Wang, Yang ; Stimpson, Jim P. / Do immigrants underutilize optometry services?. In: Optometry and Vision Science. 2015 ; Vol. 92, No. 11. pp. 1113-1119.
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abstract = "Purpose. To characterize utilization of office-based optometry services by immigration status using a nationally representative database. Methods. The 2007 to 2011 Medical Expenditure Panel Survey is used to examine adults aged 18 years and older. Respondents were classified as US natives, naturalized citizens, and noncitizens. Multivariate logistic regression analysis examined the relationship of having visited an office-based optometrist within the past 12 months by immigrant status, adjusting for age, sex, education, race/ethnicity, marital status, self-reported vision difficulty, use of corrective lenses, poverty status, insurance, language barrier and usual source of care. Oaxaca-Blinder decomposition identified factors that perpetuate or ameliorate disparities in utilization across immigrant groups. Results. The proportion of US natives who had visited an optometrist within the past year was 7.2{\%}, almost three times higher than that for noncitizens (2.5{\%}). Among respondents who reported vision difficulties, only 47.9{\%}of noncitizens used corrective lenses compared with 71.0{\%} of naturalized citizens and 71.6{\%}of US natives. Adjusting for confounding factors, multivariate logistic regression showed that naturalized citizens and noncitizen residents had significantly lower odds than US natives of receiving optometry services (naturalized citizen adjusted odds ratio, 0.77; 95{\%} confidence interval, 0.66 to 0.89; noncitizen adjusted odds ratio, 0.44; 95{\%} confidence interval, 0.36 to 0.53). Decomposition analysis suggested that 17{\%} of the disparity in utilization between noncitizens and US natives resulted from barriers to care such as language barriers, poverty, lack of insurance, and not having a usual source of health care. Conclusions. Prior literature suggests that immigrants have significantly poorer clinical vision outcomes than US natives. Our findings suggest that this disparity in clinical vision outcomes may result from underutilization of optometry services by immigrants compared with US natives. Immigrant patients may need targeted interventions that reduce barriers to care and change their perceptions so that regular eye care services are viewed as necessary and preventative.",
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