Socioeconomic status and vision care utilization in Canada: a systematic review

Objective

Despite a universal health care system, access to vision care in Canada is not necessarily equally accessible to all patients. The purpose of this review was to explore the association between socioeconomic status (SES) and vision care utilization in Canada.

Methods

Medline, Embase, CINAHL, and Cochrane were searched from inception to January 2024 for relevant articles containing original data. Studies that explored the association between SES and vision care utilization in Canadian patients were included. Risk of bias was assessed using the Newcastle–Ottawa and AXIS assessment tools. Descriptive statistics were used to summarize findings. The review was registered in PROSPERO (registration number: CRD42024502482) and followed PRISMA guidelines.

Results

The search yielded 2,670 records with 23 studies included in this review. The included studies covered all provinces and ranged in date between 1985 and 2022. The included studies explored the relationship between SES and utilization of ophthalmic care, optometric care, or both. Overall, 17 of the 23 studies found that patients of lower SES were significantly more likely to have decreased usage of vision care. Decreased vision care utilization was found for all optometry, ophthalmology care, and diabetic retinopathy screening, as well as for patients of all ages, and in all provinces.

Discussion/Conclusion

Low socioeconomic status was consistently associated with decreased vision care utilization for patients of all ages. Efforts are required to increase accessibility to vision care for low-income individuals and to improve health equity.