Association Between Social Determinants of Health and Hearing Loss and Hearing Intervention in Older US Adults

Samantha Terhaar; Dhruv Patel; Ethan Fung; Febronia Mansour; Josh F Wallace; Martin Corsten; James Ted McDonald; Stephanie Johnson-Obaseki; Alexandra E Quimby

doi:10.1097/MAO.0000000000004359

Association Between Social Determinants of Health and Hearing Loss and Hearing Intervention in Older US Adults

Otol Neurotol. 2024 Oct 21. doi: 10.1097/MAO.0000000000004359. Online ahead of print.

Authors

Samantha Terhaar¹, Dhruv Patel², Ethan Fung², Febronia Mansour², Josh F Wallace³, Martin Corsten⁴, James Ted McDonald⁵, Stephanie Johnson-Obaseki⁶, Alexandra E Quimby¹

Affiliations

¹ Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, New York.
² Norton College of Medicine, SUNY Upstate Medical University, Syracuse, New York.
³ Department of Public Health and Preventative Medicine, SUNY Upstate Medical University, Syracuse, New York.
⁴ Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
⁵ Department of Economics, University of New Brunswick, Frederickton, New Brunswick, Canada.
⁶ Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada.

PMID: 39439071
DOI: 10.1097/MAO.0000000000004359

Abstract

Objective: Estimate the prevalence of hearing loss and hearing assistance device use among older adults in the United States, and assess for associations with select social determinants of health (SDOH).

Study design: Cross-sectional US population-based study using National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 (pre-pandemic) data.

Setting: Non-institutionalized civilian adult US population.

Methods: US adults aged ≥70 years who completed NHANES audiometry exams were included. Sample weights were applied to provide nationally representative prevalence estimates of hearing loss and hearing assistance device use. Logistic regression analyses assessed associations between SDOH and both hearing loss and hearing assistance device use.

Results: The overall prevalence of hearing loss was 73.7%. Among those with nonprofound hearing loss, the prevalence of hearing assistance device use was 31.3%. Older individuals (odds ratio [OR], 6.3 [3.668-10.694] comparing ages 80+ versus 70-74 yr) and with lower education (OR, 3.8 [1.455-9.766] comparing <ninth grade versus college graduates or above) experienced a significantly elevated prevalence of hearing loss, whereas females (OR, 0.5 [0.326-0.754] versus males) and Blacks (0.5 [0.295-0.841] versus non-Hispanic Whites) had lower prevalence. Although older individuals with hearing loss had a higher prevalence of hearing assistance device use (OR, 2.1 [1.294-3.553] comparing ages 80+ to 70-74 yr), individuals of Black and other Hispanic races had a significantly lower prevalence of hearing assistance device use than non-Hispanic Whites (OR, 0.4 [0.188-0.671]; OR 0.1 [0.012-0.459], respectively), and those with no health insurance had higher prevalence of use than those who were insured (OR, 4.8 [1.307-17.371]).

Conclusion: The prevalence of hearing loss among older adults in the United States remains roughly stable compared with previous population-based estimates, whereas the prevalence of hearing assistance device use is slightly increased. Population-level disparities exist both in the prevalence of hearing loss and hearing assistance device use across SDOH.