US children from non-English-speaking households are less likely to undergo vision testing

Abstract

Purpose: To investigate the association between primary household language and vision testing among children living in the United States from 2016 to 2020. Methods: This analysis used data for children aged 3-17 years from the National Survey of Children's Health (NSCH), combining survey responses from 2016 to 2020. Primary household language and whether vision testing occurred were determined by survey responses. Complex samples logistic regression models, adjusted for insurance coverage, income (relative to the federal poverty level), race/ethnicity, educational level of household adult, and survey year, were developed to determine the likelihood of vision testing as a function of household English-language usage. Results: Among the 150,603 NSCH respondents, 9,750 (6.47%) were from non-English-speaking households. These children were less likely to undergo vision testing compared with those from English-speaking households (75.8% vs 67.6% [P < 0.001]). State requirements for vision screening among preschoolers and school-age children were associated with increased likelihood of vision testing (P < 0.05) among 3- to 5- and 12- to 17- year-olds; stratified by primary household language, this effect was greater among those from non-English-speaking households. Conclusions: In this nationally representative sample, children from non-English-speaking households were less likely than those from English-speaking ones to receive vision testing, highlighting the need to address language services, health literacy, and other potential barriers to vision services in this population.