Enough to go around

Why do people access eye care in some areas of the country, and don’t in others? And what are the barriers to accessing optometric services? Erin Dean examines inequalities in eye health.

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A decade ago, the Marmot review into health inequalities in England found that people living in the poorest neighbourhoods died on average seven years earlier than people living in the richest (Marmot, 2010). The disturbing picture of Marmot’s “social gradient in health” has only worsened. Last year, Public Health England (PHE) warned: “Between the most and least deprived areas of England, the level of inequality, or gap, in life expectancy is 9.3 years for males and 7.3 years for females” (PHE, 2018).

People in poorer areas not only die sooner, they spend more of their shortened lives in poor health or with a disability. The Marmot review found that the average difference in disability-free life expectancy was 17 years. “Inequalities are a matter of life and death, of health and sickness, of wellbeing and misery... The lower a person’s social position, the worse his or her health.”

Eye health too suffers from the problems of inequality. The main causes of sight loss in the UK are uncorrected refractive error (URE), which accounts for 39% of cases (Royal National Institute of Blind People (RNIB), 2018). 

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