The relationship between visual function and social determinants of health in pediatric ophthalmology patients is unclear. Our study evaluated the feasibility of screening for social determinants of health in ophthalmology clinics, assess the prevalence of these risk factors, and to clarify the relationship between social determinants of health and visual function.
An institution approved survey on social determinants of health risk factors was completed by 145 patients from five pediatric ophthalmology outpatient clinics in British Columbia. Medical charts of survey participants were reviewed to determine diagnoses and level of visual function. Descriptive statistics, univariate, and multivariate analysis were performed.
Socioeconomic risk factors were present in all pediatric ophthalmology settings. 56% (n=81) of participants reported having at least one risk factor. Characteristics of poverty, including annual household income, size of support network, adverse childhood experiences, and level of parental education, were not associated with level of visual function. Food insecurity, housing instability, low income, and lack of social support were all associated with a higher adverse event scores (p<0.05). Patients who experienced food insecurity were more likely (OR 7.14, 95% CI 1.47-38.44) to have an adverse childhood experience score of four or more compared to patients who did not have any risk factors.
Our study found no relationship between the level of visual function and social determinants of health risk factors. Given that all pediatric ophthalmology populations experience socioeconomic poverty, the need to establish social screening and social work support is pertinent in all pediatric ophthalmology clinics.