Repository of Research and Investigative Information

Repository of Research and Investigative Information

Dezful University of Medical Sciences

Economic inequality in unmet refractive error need in deprived rural population of Iran

(2020) Economic inequality in unmet refractive error need in deprived rural population of Iran. Journal of Current Ophthalmology. pp. 189-194. ISSN 2452-2325

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Abstract

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.

Item Type: Article
Keywords: Economic inequality Oaxaca-Blinder decomposition Rural Unmet need correctable visual impairment global vision impairment prevalence adults determinants presbyopia blindness Ophthalmology
Subjects: W General Medicine. Health Professions > W 322-323 Social Welfare through Medicine
W General Medicine. Health Professions > W 74-81 Medical Economics
Divisions: Education Vice-Chancellor Department > Faculty of Medicine > Departments of Clinical Sciences > Department of Social Medicine
Page Range: pp. 189-194
Journal or Publication Title: Journal of Current Ophthalmology
Journal Index: ISI
Volume: 32
Number: 2
Identification Number: https://doi.org/10.4103/joco.Joco₁₀₀₂₀
ISSN: 2452-2325
Depositing User: مهندس مهدی شریفی
URI: http://eprints.dums.ac.ir/id/eprint/631

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