Pediatric racial disparities in visual impairment: A conceptual framework

African American and Latino children tend to have higher rates of visual impairment and lower rates of compliance with vision care recommendations compared to whites. Issues related to vision differ from general health due to the supplemental nature of vision insurance and the social stigma associated with compliance including wearing of spectacles and eye patches. A conceptual model modified from the Institute of Medicine framework is used to explain the racial disparities of visual impairment in children. The proposed model explains the disparities as the result of the interaction among several factors including the individual and family, the environment, the healthcare system, and provider characteristics. The individual and family domain includes non-modifiable (biological predisposition) and modifiable (poverty, beliefs about vision, and management of impairment) factors. The environment includes factors such as social values and perceptions. The provider's characteristics domain involves providers' training and communication style. The health care system domain includes health care policies and insurance coverage. These domains interact with each other to affect the process of care. The process of care then influences the disparity outcome. A conceptual framework to understand the vision health disparities can be useful when working to increase compliance with eye care recommendations in children.