Unmet refractive need and its determinants in Shahroud, Iran

Emamian, Mohammad Hassan; Zeraati, Hojjat; Majdzadeh, Reza; Shariati, Mohammad; Hashemi, Hassan; Fotouhi, Akbar

doi:10.1007/s10792-012-9567-8

Cited by 12 publications

(24 citation statements)

References 21 publications

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“…The negative value of this variable in the explained portion (favouring the low economic group) implies that the group with a lower economic status is more influenced by changes in eye care utilisation than the group with a high economic status. We have already shown that 5.7% of the participants of this study had an unmet need in visual acuity,18 and a significant percentage will certainly exhibit the same condition for near vision as well. Thus it can be concluded that the integration of optometry (ophthalmology) examinations in the ‘family physician’ programme currently running across Iran19 is an essential measure to achieve equality in visual health.…”

Section: Discussionmentioning

confidence: 58%

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Economic inequality in presenting near vision acuity in a middle-aged population: a Blinder–Oaxaca decomposition

et al. 2013

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Section: Discussionmentioning

confidence: 58%

“…These factors have already been emphasised in other outcomes of the study 18 20. The important finding is that, although some studies have emphasised a relationship between blindness and economic status/poverty4 6 or between cataract and poverty,21 none has considered the role of economic inequality in near vision or presbyopia.…”

Section: Discussionmentioning

confidence: 98%

Economic inequality in presenting near vision acuity in a middle-aged population: a Blinder–Oaxaca decomposition

et al. 2013

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“…According to a previous study, 5.7% of the participants had unmet visual acuity needs. 38 Therefore, access to medical eye care services can be considered as an important factor in these decomposition approaches in order to increase the contribution of deterministic or explained components. Hence, we suggest the role of this factor and other related factors be assessed in future studies.…”

Section: Discussionmentioning

confidence: 99%

Economic Inequality in Presenting Vision in Shahroud, Iran: Two Decomposition Methods

Mansouri

Emamian

Zeraati

et al. 2017

Int J Health Policy Manag

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Background: Visual acuity, like many other health-related problems, does not have an equal distribution in terms of socio-economic factors. We conducted this study to estimate and decompose economic inequality in presenting visual acuity using two methods and to compare their results in a population aged 40-64 years in Shahroud, Iran. Methods: The data of 5188 participants in the first phase of the Shahroud Cohort Eye Study, performed in 2009, were used for this study. Our outcome variable was presenting vision acuity (PVA) that was measured using LogMAR (logarithm of the minimum angle of resolution). The living standard variable used for estimation of inequality was the economic status and was constructed by principal component analysis on home assets. Inequality indices were concentration index and the gap between low and high economic groups. We decomposed these indices by the concentration index and BlinderOaxaca decomposition approaches respectively and compared the results. Results: The concentration index of PVA was -0.245 (95% CI: -0.278, -0.212). The PVA gap between groups with a high and low economic status was 0.0705 and was in favor of the high economic group. Education, economic status, and age were the most important contributors of inequality in both concentration index and Blinder-Oaxaca decomposition. Percent contribution of these three factors in the concentration index and Blinder-Oaxaca decomposition was 41.1% vs. 43.4%, 25.4% vs. 19.1% and 15.2% vs. 16.2%, respectively. Other factors including gender, marital status, employment status and diabetes had minor contributions. Conclusion: This study showed that individuals with poorer visual acuity were more concentrated among people with a lower economic status. The main contributors of this inequality were similar in concentration index and Blinder-Oaxaca decomposition. So, it can be concluded that setting appropriate interventions to promote the literacy and income level in people with low economic status, formulating policies to address economic problems in the elderly, and paying more attention to their vision problems can help to alleviate economic inequality in visual acuity.

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“…Due to the marked economic burden of uncorrected RE, 3 8 many researchers made several efforts to estimate the prevalence of unmet and met RE needs. 9 10 11 12 13 14 15 16 17 18 19 20 21 Although their results were very controversial, most of them reported a need for identifying the factors affecting the met and unmet needs. 9 12 14 15 For example, some recent studies underlined the role of enabling and predisposing variables, including age, education, living place, and even the type of RE.…”

Section: Introductionmentioning

confidence: 99%

“… 9 12 14 15 For example, some recent studies underlined the role of enabling and predisposing variables, including age, education, living place, and even the type of RE. 9 11 12 13 14 15 17 19 20 22 23 …”

Section: Introductionmentioning

confidence: 99%

Economic Inequality in Unmet Refractive Error Need in Deprived Rural Population of Iran

Yekta

Hashemi

Pakzad

et al. 2020

Journal of Current Ophthalmology

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Purpose: To determine economic inequality in unmet refractive error (RE) need and its determinants in deprived rural population of Iran. Methods: In this population-based study, two villages were randomly selected from among underserved villages of Iran. After selecting the participants, optometric examinations, including uncorrected and corrected visual acuity and subjective and manifest refraction, were done for all the participants. Then, unmet need for glasses was determined. Concentration index (C) was used to assess inequality, and Oaxaca–Blinder decomposition method was applied to decompose the gap between the two groups based on the determinants. Results: Of 3851 samples, 3314 participated in the study (response rate = 86.05%). The data of 3255 participants were used for analysis. The value of C and 95% confidence interval (CI) was −0.088 (−0.157 to −0.020), indicating a pro-poor inequality in unmet need. The prevalence (95% CI) of unmet need was 11.74% (9.25–14.22) in the poor and 6.51% (4.96–8.06) in the rich, with a gap of about 5% in favor of the rich (P < 0.001). A marked percentage of the gap was due to the explained portion (b = 5.73; P = 0.031). In the explained portion, the variable of economic status (b = 3.48; P = 0.004) and myopia (b = 0.88; P = 0.031) caused inequality in favor of the rich and against the poor, respectively. In the unexplained portion (b = −0.51; P = 0.372), the variables of education (P = 0.002) and place (P = 0.001) had statistically significant effects on inequality. Conclusions: There is a significant pro-poor economic inequality in the prevalence of unmet need in rural areas of Iran. Although part of this inequality is related to variables such as education and myopia, a major portion (two thirds) of this inequality may be due to the direct effect of economic inequality.

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Unmet refractive need and its determinants in Shahroud, Iran

Cited by 12 publications

References 21 publications

Economic inequality in presenting near vision acuity in a middle-aged population: a Blinder–Oaxaca decomposition

Economic inequality in presenting near vision acuity in a middle-aged population: a Blinder–Oaxaca decomposition

Economic Inequality in Presenting Vision in Shahroud, Iran: Two Decomposition Methods

Economic Inequality in Unmet Refractive Error Need in Deprived Rural Population of Iran

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