Geographical Variation in Ophthalmological Care Correlates to Economic Well-being in Florida

Abstract

Purpose: This study aims to quantify the relationship between economic disadvantage and access to eye care in the state of Florida by synthesizing multiple metrics of care. The access metrics presented can help policymakers target interventions to areas most in need and monitor progress towards improving access. Material and Methods: Data from the Center for Medicaid and Medicare Services were analyzed with the Distressed Community Index (DCI), a metric developed by Economic Innovation Group which stratifies zip codes into 5 levels of economic well-being. An association between DCI and eye providers per capita was assessed using a Kruskal-Wallis test. Included are the 920 Florida zip codes included in the Economic Innovation Group’s Distressed Community Index (DCI). The Economic Innovation Group states all zip codes in the United States with populations greater than 500 are included in the DCI data set. Results: In Florida, 42.6% of zip codes have neither an ophthalmologist nor an optometrist. Number of providers per capita significantly differs by DCI category (p<.001) with areas of lowest deprivation having an average of 0.23 ± 0.37 providers per thousand residents and areas of highest deprivation having 0.09 ± 0.19 providers per thousand. DCI quintiles of highest deprivation were significantly more likely to not have an eye provider (p<.001) with 30.5% of zip codes in the lowest deprivation quintile having no providers vs. 62.2% in that of the highest deprivation quintile. Discussion: Findings indicate that economically disadvantaged zip codes have significantly less access to eye care compared to their more affluent counterparts. Given that Florida has the highest current prevalence and projected per capita prevalence of visual impairment, investigation and efforts to maximize access to ophthalmological care is paramount.