Population Estimates Research Articles

Refining Cellular Data for Accurate Trip Chain Identification: A Novel Approach for Urban Travel Analysis

Cellular data play a crucial role in supporting travel demand assessment and urban traffic planning because of their cost-effectiveness and extensive coverage. However, inherent inaccuracies, such as imprecise positioning, data duplication, and abnormal communication frequencies, hinder their ability to depict travelers’ trips accurately. In this paper, we present a novel approach to mitigate these issues by employing base station mapping to refine positioning data, eliminating duplicates and abnormal frequency records. This refinement enables more effective utilization of cellular data for trip chain identification. We address the ping-pong handover effect by employing a finite automaton machine and an approximate nearest neighbor searching method with carefully selected seeds to identify activities. Our method’s accuracy is validated through ground truth value analysis, focusing on permanent resident population estimation and metro passenger flow estimation. Furthermore, we demonstrate the practical effectiveness and value of our proposed method through a series of representative applications in a real-world case study in the city of Nanning, Guangxi Province, China.

Routine vaccination coverage at ages 2 and 7, before, during, and after the COVID-19 pandemic: Results from the STARVAX surveillance system.

A decline in routine vaccination coverage in children has been observed after the onset of the COVID-19 pandemic, but it is unclear whether these declines were sustained over time. This analysis assessed changes in vaccination coverage at ages 2 and 7years for routinely administered vaccinations before, during, and after the COVID-19 pandemic. Vaccination coverage was measured using yearly data from the Standardized Reporting on Vaccination (STARVAX) surveillance system between December 31, 2019, and December 31, 2023. Four provinces (Alberta, Saskatchewan, Manitoba, and New Brunswick) and one territory (Yukon) produced reports from their immunization registries and provided the Public Health Agency of Canada with the numbers of vaccinated 2-year-old and 7-year-old children. Population estimates from Statistics Canada and the Yukon Bureau of Statistics were used as the denominators. There was a decline in vaccination coverage in 2023 compared to 2019. In 2-year-olds, coverage for one dose of the measles, mumps, and rubella (MMR) vaccine and four doses of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine decreased from 89.5% to 82.5% and from 79.9% to 72.1%, respectively. Among 7-year-olds, DTaP (up-to-date) and MMR (two doses) vaccination coverage decreased from 77.1% to 68.8% and 86.3% to 75.6%, respectively. These declines are of concern and suggest that health care professionals should provide parents with accurate information regarding vaccines and encourage them to have their children vaccinated and keep vaccinations up to date.

Bayesian Model Projecting Cardiovascular Disease Related Mortality Trends in the United States.

As future cardiovascular disease mortality trends have public health implications, we aimed to project ischemic heart disease (IHD), cerebrovascular disease (CeVD), and heart failure (HF) mortality rates for adults (40-79 years). In this population-level study, we linked the yearly mortality rates (per 100 000 US residents) (2000-2019) with IHD, CeVD, or HF as the primary cause of death from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research with the midyear US population estimates (2000-2035) for adults (40-79 years). We calculated the observed age-standardized mortality rates (2000-2019) (per 100 000 residents) (aSMR) and fitted Bayesian age-period-cohort models to project aSMR for IHD, CeVD, and HF up to 2035 in the United States. Between 2019 (last year of observed data) and 2035 (last year of projected results), the US population (40-79 years) will increase by 16% and age. The IHD aSMR will reduce from 111.9 (in 2019) to 81.8 (66.7-96.9) in 2035, an effect observed for all age groups. The CeVD aSMR will remain comparable between 2019 (37.4) and 2035 (38.6 [30.7-46.5]). The HF aSMR will increase from 16.5 in 2019 to reach 30.9 (13-48.8) in 2035; such increases were observed in all age groups. In the United States, between 2020 and 2035, the aSMR for IHD is expected to decrease, for CeVD will remain stable, and for HF will increase substantially. These data can inform resource allocation for future public health initiatives.

Digging for answers: defining the external architecture of the southern hairy-nosed wombats’ (Lasiorhinus latifrons) subterranean excavations

The southern hairy-nosed wombat (Lasiorhinus latifrons) is a large, nocturnal, herbivorous, burrowing marsupial, endemic to the semi-arid and arid regions of southern Australia. The active burrow of L. latifrons is used as the primary feature in population estimations. Therefore, accurate identification of an active burrow is vital, especially when other burrow-like structures exist. Entrance attributes such as width, height, the length and angle of the path leading to the entrance, and signs of wombat activity are indistinguishable between the different structures, making differentiation between them impossible without inspecting the structure beyond the entrance. Structures leading from entrances were identified in the field as possible burrows, blinds, and go-throughs. An unmanned aerial vehicle provided accurate images from immediately above 12 active wombat warren systems in the mid-north of South Australia, to support ground-truthing for mapping and verification of these structures. Active possible burrows (APB) were found to occur in proportionally lower numbers than the active non-burrow structures (ANBS) of blinds and go-throughs, varying in proportion from as high as 1:2 to as low as 1:11 (APB:ANBS). Defining an active burrow and other tunnels leading from an entrance increases accuracy in burrow identification used in population estimations, while recognising the existence of additional architectural features is vital to understanding the functional potential of L. latifrons as an ecosystem engineer.

Prevalence of Cannabis Use Disorder Among Primary Care Patients with Varying Frequency of Past-Year Cannabis Use.

Valid, single-item cannabis screens for the frequency of past-year use (SIS-C) can identify patients at risk for cannabis use disorder (CUD); however, the prevalence of CUD for patients who report varying frequencies of use in the clinical setting remains unexplored. Compare clinical responses about the frequency of past-year cannabis use to typical use and CUD severity reported on a confidential survey. Among adult patients in an integrated health system who completed the SIS-C as part of routine care (3/28/2019-9/12/2019; n = 108,950), 5000 were selected for a confidential survey using stratified random sampling. Among 1688 respondents (34% response rate), 1589 who reported past-year cannabis use on the SIS-C were included. We compared patients with varying frequency of cannabis use on the SIS-C (< monthly, monthly, weekly, daily) to survey responses on the Composite International Diagnostic Interview Substance Abuse Module for CUD (any and moderate-severe CUD) and cannabis exposure measures (typical use per-week, per-day). Adjusted multinomial (categorical) and logistic regression (binary), weighted for population estimates, estimated the prevalence of outcomes across frequencies. Patients were predominantly middle-aged (mean = 43.3years [SD = 16.9]), male (51.8%), white (78.2%), non-Hispanic (94.0%), and commercially insured (68.9%). The prevalence of any and moderate-severe CUD increased with greater frequency of past-year cannabis use reported on the SIS-C (p-values < 0.001) and ranged from 12.7% (6.3-19.2%) and 0.9% (0.0-2.7%) for < monthly to 44.6% (41.4-47.7%) and 20.3% (17.8-22.9%) for daily use, respectively. Greater frequency of use on the SIS-C in the clinical setting corresponded with greater per-week and per-day use on the confidential survey. Among patients who reported past-year cannabis use as part of routine screening, the prevalence of CUD and other cannabis exposure measures increased with greater frequency of cannabis use, underscoring the utility of brief cannabis screens for identifying patients at risk for CUD.

Analyzing Potential Non-Ignorable Selection Bias in an Off-Wave Mail Survey Implemented in a Long-Standing Panel Study

Abstract Typical design-based methods for weighting probability samples rely on several assumptions, including the random selection of sampled units according to known probabilities of selection and ignorable unit nonresponse. If any of these assumptions are not met, weighting methods that account for the probabilities of selection, nonresponse, and calibration may not fully account for the potential selection bias in a given sample, which could produce misleading population estimates. This analysis investigates possible selection bias in the 2019 Health Survey Mailer (HSM), a sub-study of the longitudinal Health and Retirement Study (HRS). The primary HRS data collection has occurred in “even” years since 1992, but additional survey data collections take place in the “off-wave” odd years via mailed invitations sent to selected participants. While the HSM achieved a high response rate (83 percent), the assumption of ignorable probability-based selection of HRS panel members may not hold due to the eligibility criteria that were imposed. To investigate this possible non-ignorable selection bias, our analysis utilizes a novel analysis method for estimating measures of unadjusted bias for proportions (MUBP), introduced by Andridge et al. in 2019. This method incorporates aggregate information from the larger HRS target population, including means, variances, and covariances for key covariates related to the HSM variables, to inform estimates of proportions. We explore potential non-ignorable selection bias by comparing proportions calculated from the HSM under three conditions: ignoring HRS weights, weighting based on the usual design-based approach for HRS “off-wave” mail surveys, and using the MUBP adjustment. We find examples of differences between the weighted and MUBP-adjusted estimates in four out of ten outcomes we analyzed. However, these differences are modest, and while this result gives some evidence of non-ignorable selection bias, typical design-based weighting methods are sufficient for correcting for it and their use is appropriate in this case.

Agent-Based Geosimulation of Yayoi Period Population Dynamics in Kyushu, Japan

Current scholarship in Japanese archaeology recognizes the people and culture of the Yayoi period as being descended from both continental migrants (Toraijin) and the native inhabitants (Jomon people). However, the number of migrants that came to Japan and the degree to which they were directly responsible for the development of Yayoi culture is a topic of debate. Using northern Kyushu as a case study, the author employs an agent-based simulation based on geospatial data to model the spread of population, rice agriculture, and continental genetics during the Early Yayoi period. Multiple simulations are performed with varying parameters related to migrant population size, marriage customs, and the ratio of men to women amongst migrants to test their effect on the demographics of the Yayoi period. Simulation results were compared to population estimates and the distribution of mitochondrial DNA in order to determine their validity. Experiment 1 showed that the average number of continental migrants was likely in the order of magnitude of 10s of people per year (approx. 40 to 50) during the first 500 years of the Yayoi period. Experiment 2 demonstrated that polygyny can lead to increased population growth and aids in the spread of continental genetics, but without more rigorous evaluation criteria it is difficult to conclude whether it was practiced during the period. The methods used in this study demonstrate how agent-based simulations can model realistically sized populations moving through geographic space by basing simulation inputs on geospatial data and population estimates.

Using the Capture–Recapture Technique to Supplement a Point-in-Time Count of Homeless Adults in Kittitas County, Washington

Abstract Capture–recapture (CRC) is a method of population estimation pioneered in biology that allows the surveyor to approximate the proportion of individuals who evaded sampling efforts (i.e., captures) based on repeated samples from the same population. The current national standard for estimating homelessness is a single-day enumeration called the point-in-time (PIT) count. By using a local community action agency’s homeless outreach program and a cold weather shelter as two distinct sampling sources to capture data using CRC methodology, the current study sought to estimate the homeless population in Kittitas County, Washington, and compare CRC with PIT count estimates. Four months of data collection for the two sampling sources yielded an estimate of 115 (95% CI [93, 137]) homeless individuals in the county using CRC methodology. The PIT count conducted in the same year sampled 61 individuals, supporting the idea that cross-sectional enumeration (i.e., PIT counts) underestimate the homeless population and could be supplemented by CRC methods, particularly in rural areas where resources to conduct PIT counts may be limited. Greater accuracy in homelessness enumeration may aid in advocacy efforts, provide baseline data for researching interventions designed to reduce homelessness, and yield statistics to better guide legislative and policy initiatives.

Public health unit funding per capita and seasonal influenza vaccination among youth and adults in Ontario, Canada in 2013/2014 and 2018/2019

BackgroundInfluenza vaccines are crucial in reducing the risk of influenza symptoms. We aimed to: (1) estimate the association between public health unit (PHU) funding per capita and influenza vaccination among...

Nationally representative estimates of food insecurity during COVID‐19: An investigation of the Food Insecurity Experience Scale in Australia

AbstractThe purpose of this paper was to measure the prevalence of food insecurity (FI) in Australia during the COVID‐19 pandemic using the 8‐item Food Insecurity Experience Scale (FIES). Employing the Household, Income and Labour Dynamics in Australia (HILDA) survey, Rasch models alongside a discrete method were used to investigate the severity of FI and robustness of the 8‐item FIES during 2020–2021. Our results indicate that during 2020–2021, 6.47% of Australians experienced moderate or severe FI and 2.93% experienced severe FI. Validation tests following United Nations guidelines show similar weighted and unweighted results and consistency with the discrete method. Infit and outfit metrics, alongside measures of reliability and residual correlations, were all within the expected range. We conclude that the FIES administered as part of Wave 20 of the HILDA survey was a suitable instrument for measuring the prevalence of FI at a representative population level. Although Australia has been measuring FI for 40 years, it has been characterised by measurement inconsistency, inadequacy and infrequency, resulting in insufficient data for policymaking. Reliable representative population estimates of the extent of FI in Australia provides critical intelligence for an effective policy response.

Predicting the long-term effects of electronic cigarette use on population health: a systematic review of modelling studies

ObjectiveTo systematically review and synthesise the findings of modelling studies on the population impacts of e-cigarette use and to identify potential gaps requiring future investigation.Data source and study selectionFour databases...

Labor supply effects of a universal cash transfer

I investigate the labor supply effects of the introduction of an exceptionally large unconditional cash benefit. I exploit the unique design of the child benefit program in Poland to identify the effects of the monthly transfer in a difference-in-differences design. The transfer had no short-term effects but caused sizable negative medium-term effects on household labor supply. In the medium run, population estimates indicate that for every extra 100 dollars in monthly child benefit transfers households received, they reduced their after-tax earnings by 25 dollars, spent 32 dollars on consumption, and saved 43 dollars. These negative labor supply effects are much larger and much more precisely estimated among households with low socioeconomic status. Additional evidence shows that the program had a positive impact on investments in human capital and home production efficiency.

A brown bear population estimate for Finnmark County, North Norway

We have estimated the average number of brown bears Ursus arctos L. in Finnmark, the northernmost county in Norway. We started by estimating the number of bears where reproduction has been documented in the Pasvik Valley (1,330 km2) and published densities of brown bears from 1) female concentration areas in Sweden and northern Russia (ca. 5 bears per 1 000 km2), and 2) an intensively studied area in northern Sweden (12.6 bears per km2). We then expanded this estimate to all of Finnmark using observations of bears far from the Pasvik Valley. We estimate that there are on average 7 - 17 bears in Sør-Varanger Municipality, and totally 8 - 21 in Finnmark County. The brown bears in Finnmark comprise 31 - 38% of the total estimated number of bears in Norway of 26 - 55, respectively. An area of only 1,330 km2 in the Pasvik Valley is the major Norwegian brown bear area, contains about 30% of the bears in Norway, and is the area where reproduction is observed most regularly.

Prevalence of Glaucoma Among US Adults in 2022

Glaucoma is the leading cause of irreversible blindness worldwide and, in the US, disproportionately affects people from racial and ethnic minority groups. Glaucoma prevalence has not been estimated for the US in more than a decade, and state- and county-level estimates are not available. To estimate glaucoma and vision-affecting glaucoma prevalence by demographic factors and US state and county for the Centers for Disease Control and Prevention's Vision and Eye Health Surveillance System (VEHSS). This meta-analysis used data from the National Health and Nutrition Examination Survey (2005-2008), Medicare fee-for-service claims (2019), IBM MarketScan commercial insurance claims (2016), population-based studies of eye disease (1985-2003), and 2022 population estimates from the US Census Bureau. PubMed was searched for population-based studies of glaucoma prevalence published between 1991 and 2016. Bayesian meta-regression methods were used to estimate the prevalence of glaucoma and vision-affecting glaucoma stratified by age, undifferentiated sex/gender (a measure that captures an unclear mix of aspects of sex and or gender), race and ethnicity, and US county and state. Prevalence of any type of glaucoma (open or closed angle) among people 18 years or older and vision-affecting glaucoma, defined as glaucoma and a visual field abnormality. For 2022, an estimated 4.22 million people (95% uncertainty interval [UI], 3.46 million to 5.23 million) in the US were living with glaucoma, with a prevalence of 1.62% (UI, 1.33%-2.00%) among people 18 years or older and 2.56% (UI, 2.10%-3.16%) among people 40 years or older. An estimated 1.49 million people (UI, 1.17 million to 1.90 million) were living with vision-affecting glaucoma, with a prevalence of 0.57% (UI, 0.45%-0.73%) among people 18 years or older and 0.91% (UI, 0.71%-1.16%) among people 40 years or older. Prevalence of glaucoma among people 18 years or older ranged from 1.11% (UI, 0.89%-1.40%) in Utah to 1.95% (UI, 1.57%-2.39%) in Mississippi. Black adults had a prevalence of 3.15% (UI, 2.32%-4.09%) compared with 1.42% (UI, 1.10%-1.85%) among White adults; adults in the Hispanic and all other racial and ethnic categories combined had a prevalence of 1.56% (UI, 1.13%-2.06%). This meta-analysis found that an estimated 2.56% of people 40 years or older have glaucoma, slightly more than estimated by previous studies. Black individuals are disproportionately affected. Prevalence estimates at the state and county level can help guide public health planning.

From BpTRU to OMRON: The impact of changing automated blood pressure measurement devices on adult population estimates of blood pressure and hypertension.

In Cycle 7 (2022), the Canadian Health Measures Survey (CHMS) introduced the OMRON (OM) IntelliSense HEM-907XL blood pressure (BP) monitor after using the BpTRU (BT) BPM-300 BP monitor for six cycles. This study assessed differences between adult BP values measured by both devices and whether equations could be developed to compare BP measurements taken using the two devices. In Cycle 6 (2018 to 2019) of the CHMS, BP was measured using BT and OM devices. Between-device estimates of systolic BP (SBP), diastolic BP (DBP), and hypertension prevalence were compared for 1,072 adults aged 18 to 79 years. Sex, age, body mass index (BMI), and the use of antihypertensive medication were examined in linear regression models to predict SBP and DBP values measured with OM based on those measured with BT. Average SBP measured with OM was 6 millimetres of mercury (mmHg) higher than average SBP measured with BT, and average DBP measured with OM was 2 mmHg lower than DBP measured with BT. Hypertension prevalence based on OM readings was 35.4%, compared with 34.0% based on BT readings. Between-device BP differences varied in magnitude by sex, age group, and BMI category. Average model-predicted estimates of BP were comparable to measured estimates, but predicted values were lower at higher levels of BP. Switching BP monitors will substantively affect population estimates of adult SBP and DBP but may have less impact on estimates of adult hypertension prevalence. The prediction equations proposed in this study can be applied to adult BP data from cycles 1 to 6 of the CHMS for comparison with BP measurements taken in Cycle 7, with some caveats. The impact of changing to the OM monitor in Cycle 7 should be acknowledged when reporting estimates of adult BP based on the CHMS.

Epidemiology of Sports-Related Tendon Ruptures Presenting to Emergency Departments in the United States.

Participation in recreational and competitive sports can predispose people to musculoskeletal injuries. Chronic overuse with insufficient recovery, overloading, and direct contact can result in acute primary tendon ruptures. There is scarce literature regarding the epidemiology of sports-related acute primary tendon ruptures in the United States (US). To identify the incidence rate (IR) of sports-related acute primary tendon ruptures presenting to US emergency departments using the National Electronic Injury Surveillance System (NEISS) database and describe the trends in the IR from 2001 to 2020. Descriptive epidemiology study. The NEISS database was queried using injury case narratives; cases with a clear diagnosis of an acute primary tendon rupture were included in the final analysis. National estimates, estimated IRs (reported as per 1,000,000 person-years at risk), and temporal trends in the annual IR (reported as average annual percent change) of acute primary tendon ruptures were calculated using NEISS sample estimates and US Census Bureau population estimates. An estimated total of 141,382 patients (95% confidence interval [CI], 107,478-175,286) presented to US emergency departments with a sports-related tendon rupture over the study period (IR, 22.9 person-years at risk [95% CI, 17.4-28.3]). The mean age was 37.7 years (95% CI, 37.0-38.5). Of all cases of a tendon rupture identified from 2001 to 2020, 60.1% were secondary to exercise/sports-related injury mechanisms. An Achilles tendon rupture was the most common injury, representing 55.9% of cases. Basketball was the most common sports-related injury mechanism, accounting for 36.6% of cases. The overall injury rate in male patients was 7.7 times that of female patients (IR ratio, 7.7 [95% CI, 4.4-13.5]; P < .05). The annual incidence of all sports-related tendon ruptures in the US increased significantly from 2001 to 2020 (average annual percent change, 1.9 [95% CI, 1.0-2.8]; P < .01). Recreational/competitive sports participation accounted for a large proportion of acute primary tendon ruptures in the US during the study period.

ESTUDO EPIDEMIOLÓGICO DE CASOS NOTIFICADOS POR CHIKUNGUNYA ENTRE OS ANOS DE 2019 A 2023 EM UM MUNICÍPIO DO TOCANTINS

INTRODUCTION: The Chikungunya virus is transmitted by Aedes aegypti and Aedes albopictus, causing fever and joint pain, with potential serious complications. This study aimed to analyze the incidence and epidemiological profile of Chikungunya cases in Porto Nacional, Tocantins, between 2019 and 2023. METHODOLOGY: A quantitative approach was used, based on retrospective data found in the Notifiable Diseases Information System (SINAN). The variables tested included sex, age group, education and disease progression. The incidence calculation was carried out based on population estimates provided by IBGE. RESULTS: The results indicated a significant increase in cases in 2022, representing 58% of the total, followed by a drop in 2023. The majority of cases affected women (65%) and people between 20 and 39 years old. Laboratory classification was the main diagnostic method, responsible for 60% of confirmed cases. DISCUSSION: The discussion of the results highlights the need for more effective public policies to control the spread of the virus, especially in vulnerable regions. FINAL CONSIDERATIONS: Therefore, although there was a reduction in cases in 2023, it is crucial to maintain continuous epidemiological surveillance and vector control actions to prevent future outbreaks and mitigate the impacts of Chikungunya on the population.

THE NUMBER OF DISTAL RADIAL FRACTURES IN THE ELDERLY WILL INCREASE BY MORE THAN HALF BY 2040: PREDICTION MODELLING USING NATIONAL DATA

The aim was to predict the number and incidence of distal radius fractures in Scotland over the next two decades according to age group, categorised into under 65yrs(65) and 65yrs and older (65), and estimate the potential increased operative burden.The number of distal radius fractures in Scotland was isolated from the Global Burden of Disease database and this was used, in addition to historic population data and published population estimates, to create a multivariable model allowing incorporation of age group, sex and time. A Negative Binomial distribution was used to predict incidence in 2030 and 2040 and calculate projected number of fractures. A 20.4% operative intervention rate was assumed (local data).In terms of number of fractures, there was a projected 61% rise in the 65 group with an overall increase of 2099 fractures per year from 3417 in 2020 (95% confidence interval (CI) 2960 – 3463) to 5516 in 2040 (95% CI 4155 – 5675). This was associated with 428 additional operative interventions per year for those 65yrs. The projected increase between 2020 and 2040 was similar in both sexes (60% in females, 63% in males), however the absolute increase in fracture number was higher in females. There was a 4% projected fall in the number of fractures in those 65.Incidence of distal radius fractures is expected to considerably increase over the next two decades due to a projected increase in the number of fractures in the elderly. This has implications for associated morbidity and healthcare resource use.

Integrating street-view imagery and points of interest for refining population spatialization: A case study in Wuhan City

Fine-scale population spatialization is the frontier of geosciences, it is essential for sustainable urban planning and effective resource allocation. Various approaches have been proposed to enhance population estimation accuracy using multi-source geospatial data. However, the approaches based on remote sensing data usually suffer from the problem of spatial homogeneity, while the social-sensing-based approach such as point of interest (POI) data cannot distinguish the population distribution around POIs with the same category but different scales. Thus, this study proposes a novel method that incorporates street view imagery (SVI) with POI, to enrich the semantic landscape of street-level objects and provide a visual representation of spatial heterogeneity within an urban environment. Specifically, we extract POI and SVI features at grid-, street-, and community-level, respectively, and then select modelling features based on cross-scale consistency analysis with population. After that, grid-level SVI features are adjusted by community-level SVI features to alleviate its sparsity and transiency. Finally, we train random forest (RF) at the street-level and estimate grid-level population weight for population allocation. Experiments in Wuhan City at a grid size of 100 × 100m show that our method yields higher accuracy compared to WorldPop, GPW datasets, Ye's method, and heterogeneous population attraction of POI modelling (HPA-POI), demonstrating its effectiveness in fine-scale population spatialization.

Deprivation and NHS General Ophthalmic Service sight testing activity in England in 2022-2023.

Socioeconomic deprivation is associated with an increased incidence of sight-loss. To inform potential developments in eyecare, General Ophthalmic Service (GOS) sight-testing activity was explored in relation to deprivation for GOS contractors submitting National Health Service (NHS) claims in England. Data on NHS sight-test claims for the financial year 2022-2023 were sought from NHS England (NHSE), including number of sight-tests by GOS contractors, their unique Organisation Data Service codes and postcodes and age-bands of patients accessing sight-testing. Deprivation scores were assigned to contractor practices using the Index of Multiple Deprivation (IMD) and the average number of sight-tests for all contractors within each IMD decile calculated, allowing rate of sight-testing per 1000 population per decile of deprivation to be estimated using Office of National Statistics (ONS) Lower Layer Super Output Area mid-year population estimates. Inequality was examined using the Odds Ratio (OR) and slope and relative index of inequality measures (SSI and RII). Overall, 12.94 million NHS sight-tests were provided by 5622 GOS contractors in England in 2022-2023. Most affluent decile GOS contractors undertook an average ~2200 NHS sight-tests, while in the most deprived decile, average NHS sight-tests per contractor was ~1100. Rate of sight-testing per 1000 population in the most deprived decile was one quarter of that in the most affluent, with an OR of 5.29 (95% CI 5.27-5.30), indicating those in the most affluent areas were ~five times more likely to access NHS sight-tests. Overall, SII and RII were 333.5 (95% CI 333.52-333.53) and 6.4 (95% CI 6.39-6.40), respectively, findings reflective of substantial inequality in uptake. There remains substantial unwarranted variation in uptake of NHS sight-testing, with those in more affluent areas accessing sight-testing substantially more than those in more deprived areas. Strategies are required to facilitate primary care optometry to provide more equitable access to eyecare.