Access to vision care for children from immigrant and nonimmigrant households: evidence from the National Survey of Children's Health 2018-2019

PURPOSE To investigate whether immigrant generation is associated with caregiver-reported receipt of vision testing. METHODS Nationally representative data from the 2018-2019 National Survey of Children's Health was used. The primary exposure was immigrant generation, with first generation defined as child and all reported parents born outside the United States; second generation, as child born in the United States but at least one parent born outside the United States; and third generation, as all parents in the household born in the United States. The main outcome was caregiver-reported vision testing during the previous 12 months. Odds ratios adjusted for sociodemographic characteristics and 95% confidence intervals were computed based on immigrant generation. RESULTS The sample included 49,442 US children 3-17 years of age. The proportion of children who had vision testing in any setting was lower for first- (60.3%) than third-generation children (74.6%; aOR = 0.54; 95% CI, 0.41-0.71). This association remained after excluding children without health coverage. For Hispanic children, both first- (aOR = 0.58; 95% CI, 0.36-0.94) and second-generation children (aOR = 0.73; 95% CI, 0.55-0.96) had lower odds of a vision test in any setting compared with third-generation Hispanic children. CONCLUSIONS First-generation children had lower odds of vision testing than third-generation children, even when adjusting for sociodemographic characteristics, especially in Hispanic households. ( J AAPOS 2024;28:104044)