Inequity In Corrective Eyewear Insurance In Ontario: A Repeated Cross-Sectional Study

Abstract

Background 
 Although the lack of vision insurance coverage has been linked to adverse vision outcomes, Canada still has a patchwork system that provides poor or no coverage to many of its residents. 
 Data and methods 
 We used data from the Canadian Community Health Survey (2005, 2008, 2013-2014) and logistic regressions to describe the extent to which Ontario residents reported insurance coverage for corrective eyewear after the delisting of routine eye examinations for healthy adults in 2004; and, to examine associations between socioeconomic and demographic characteristics, self-reported health and insurance coverage for corrective eyewear. 
 Results 
 We found important socioeconomic differences in the reporting of corrective eyewear insurance. Lower-SES adults were more likely to have reported public corrective eyewear coverage, whereas higher-SES adults and older adults were more likely to have reported private coverage. Overall, lower-SES adults and older adults were substantially less likely to have reported any corrective eyewear coverage. Adults and older adults in poorer health had lower odds of having reported private coverage for corrective eyewear. Relative to 2005, adults had higher odds of having reported public coverage, while older adults had lower odds of having reported public coverage for corrective eyewear in 2013 and 2014. 
 Interpretation
 Our findings reinforce the limits of the current patchwork insurance system for eye care and eyewear in Ontario. The substantial socioeconomic differences in the reporting of corrective eyewear insurance, as well as the low coverage in older adults, particularly among the poor and unhealthy, are of concern.