ISSN: 2376-127X

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Neighbourhood Deprivation and Risk of Childhood Visual Impairment: A Nationwide Study from Sweden

Xinjun Li, Jan Sundquist, Bengt Zöller and Kristina Sundquist

The purpose of the study was to examine the association between neighbourhood deprivation and incidence of hospitalisation for childhood visual impairment (VI), after accounting for family- and individual-level socio-demographic characteristics. All residents in Sweden aged 2-11 years were followed between January 1, 2000 and December 31, 2010. Childhood residential addresses were geocoded and classified according to neighbourhood deprivation (an index of low education, low income, unemployment, and receipt of welfare assistance). Data were analysed by multilevel logistic regression, with family- and individual-level characteristics at the first level and level of neighbourhood deprivation at the second level. During the study period, among a total of 643,304 children, 1056 were hospitalised with childhood VI. Age-adjusted cumulative hospitalisation rates for childhood VI increased with increasing level of neighbourhood deprivation. In the study population, 1.5 per 1000 and 2.4 per 1000 children in the least and most deprived neighbourhoods, respectively, were hospitalised with childhood VI. The odds ratio (OR) for hospitalisation for childhood VI for those living in high-deprivation neighbourhoods versus those living in low-deprivation neighbourhoods was 1.49 (95% confidence interval (CI) =1.20–1.86). High neighbourhood deprivation remained significantly associated with higher odds of childhood VI after adjustment for family- and individual-level socio-demographic characteristics (OR=1.33, 95% CI=1.05–1.68, p=0.016). This study is the largest so far on neighbourhood influences on childhood VI. Our results suggest that neighbourhood is associated with incidence of hospitalisation for childhood VI independently of family- and individual-level socio-demographic characteristics.