Correlation of Cataract Surgical Rates with Economic Development, Social Indices and Public Health Indices

1. Emmy Li
2. Dennis Lam

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong

Purpose:
This study aims to assess the correlation between cataract surgical rates (CSR) and economic development, selected social and public health indices, and to identify possible determinants of CSR at a macro level.

Methods:
This is an ecological study of 101 countries in five continents with different levels of economic development, socio-demographic characteristics and healthcare systems. CSR were obtained from WHO website and OECD Health Data. GDP per capita and selected social and public health indices were collected from the CIA website. Correlation between CSR and GDP per capita, urbanization, Gini coefficient (a measure of income inequality), illiteracy rate, labor force in agriculture, infant mortality rate (IMR) and life expectancy at birth were studied followed by an exploration of their interaction.

Results:
CSR was positively correlated with GDP per capita (Spearman's rho=0.83), urbanization (rho=0.66) and life expectancy at birth (rho=0.847). There were negative associations between CSR and unemployment rate (rho=-0.34), population below poverty line (rho=-0.70), Gini coefficient (rho=-0.52), illiteracy rate (rho=-0.70), labor force in agriculture (rho=-0.80) and IMR (rho=-0.86). An interaction effect was found between GDP per capita and urbanization, unemployment rate, Gini coefficient and life expectancy at birth.

Conclusion:
Apart from the level of GDP per capita, countries with less urbanization, high unemployment, high percentage population below poverty line, high income inequality, high illiteracy rate, majority of labor force in agriculture as well as high IMR and low life expectancy suggesting suboptimal healthcare provision, appear to have low CSR.