Socioeconomic mechanisms of myopia boom in China: a nationwide cross-sectional study

Abstract

Objectives: To assess the association between socioeconomic development and the myopia boom in China.

Design: Nationwide cross-sectional study.

Setting: We used data from the China Family Panel Study (CFPS 2010), and the Chinese National Survey on Students' Constitution and Health (CNSSCH 2010).

Participants: Participants included 33 600 individuals and 14 226 families from the CFPS 2010, and 86 199 students aged 7-12 years from the CNSSCH 2010.

Measures: The main measure was students' visual impairment (defined as Snellen visual acuity ≤20/25 (0.8) in the worse eye) rate of each province (or municipality or autonomous region); other measures included the Gini coefficient of property, logarithm of average property, Gini coefficient of education, average education duration and return-to-education rate of each province (or municipality or autonomous region). The visual impairment rate was calculated using students' data, aged 7-12 years, from the CNSSCH 2010. The Gini coefficient of property and logarithm of average property were calculated using the families' data from the CFPS 2010; the Gini coefficient of education, average education duration and return-to-education rate were calculated using individuals' data aged 18-44 years from the CFPS 2010.

Results: The urban environment (coefficient: 0.209; p<0.001), Gini coefficient of property (coefficient: 1.979; p=0.005), logarithm of average property (coefficient: 0.114; p<0.001), average education duration (coefficient: 0.041; p<0.001) and return-to-education rate (coefficient: 0.195; p<0.001) were positively associated with the logit function of visual impairment rate.

Conclusions: Economic development may promote an increased desire to pursue wealth. Regarding high return to education and a fairly competitive education system, individuals are likely to pursue wealth through education, which is associated with a heavier education burden and higher prevalence rates of myopia.

Keywords: epidemiology; ophthalmology; public health.