Eyeing the Difference: A Cross-Sectional Study Analyzing Vision Screening Disparities in Public vs Private Daycares in East-Central Alabama

Objective: This study aims to evaluate disparities in vision screening outcomes among children attending Head Start programs compared to those in private daycare settings in East-Central Alabama. It further explores the implications of these disparities for improving early childhood vision care policies and interventions. Methods: Data from Impact America: FocusFirst were analyzed for screenings conducted in Alabama between 2019 and 2024. A total of 9266 children were screened, including 3143 from Head Start centers and 6123 from private daycare facilities. The failure rates of vision screenings were compared between the two groups across six counties in Central Alabama using chi-square tests and Cochran-Mantel-Haenszel statistics. Results: The analysis revealed that children in Head Start centers had higher failure rates in vision screenings compared to those in private daycare settings. Statistical significance was observed in four counties: Chambers, Lee, Macon, and Tallapoosa. Children attending Head Start programs were 1.59 times more likely to fail vision screenings than their peers in private daycare centers (p Conclusions: Children in publicly funded daycare programs, such as Head Start programs, are more likely to fail vision screenings than those in private daycare settings, reflecting significant disparities in eye health. The findings emphasize the need for timely interventions to improve health and learning outcomes for all children. These interventions may include mandatory vision screenings, increased parental education, and enhanced follow-up care. Further research is necessary to identify and address specific barriers contributing to these disparities.