Socioeconomic position and eye health outcomes: identifying inequality in rapid population-based surveys
To ensure equity in achieving universal health coverage, it is essential to monitor health outcomes disaggregated by socioeconomic position (SEP). This study aimed to assess the socioeconomic gradient or inequality in key eye health outcomes among adults aged 50 years and older in The Gambia, using four different SEP measures. The measures included an objective asset-based measure and three subjective measures of relative SEP. Results showed that subjective household food adequacy and income sufficiency demonstrated a socioeconomic gradient in point estimates of vision impairment and cataract surgical coverage. People with inadequate household food and insufficient income had worse vision impairment and cataract surgical coverage compared to those with adequate food and income. However, the subjective economic ladder question and the objective asset-wealth measure did not demonstrate any socioeconomic gradient in the eye health outcomes. The study recommends pilot-testing self-reported food adequacy and income sufficiency as SEP variables in vision and eye health surveys in other locations to assess their feasibility, reliability, and acceptability. This research is crucial in understanding eye health inequalities and in monitoring and evaluating policies and programs aimed at addressing inequities in eye health outcomes.