What are the disparities in socioeconomic status and health care utilization in hearing-impaired children?
Explore this issue:April 2011
Background: Multiple barriers potentially contribute to health disparities experienced by children with hearing loss. These can include communication barriers, fear, mistrust and frustration with the health care system, medical and non-medical costs and the logistics of care. Although health disparities have been described in these children, designated research into socioeconomic disparities among children with hearing loss is limited.
Study design: Cross-sectional analysis of stacked data from 1997 to 2003 National Health Interview Survey.
Setting: Departments of Otolaryngology-Head and Neck Surgery, Obstetrics and Gynecology, Johns Hopkins University School of Medicine, and the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore.
Synopsis: Children were grouped according to three levels of hearing ability, and various forms of analysis were used to test the association of sociodemographic variables with hearing status. Of 76,012 children in the sample, 2.6 percent had some hearing loss and 0.43 percent had marked hearing loss. Families of hearing-impaired children were more likely to report poorer health status. They were also more likely to be on Medicaid and live in single-mother households and below the poverty level. Children with mild and marked hearing impairment were less likely to be able to afford prescription medications and less likely to have access to mental health or dental services.
A limitation of the study was that deaf individuals are not oversampled in the survey in the same way that black and Hispanic persons are, so the number of those who have ‘‘a lot of trouble hearing’’ or are ‘‘deaf’’ was small compared with the total number of participants.
Bottom line: There is a disparity in family income levels between children who are hearing-impaired and children with good hearing. Additionally, families of children with hearing loss live closer to the poverty level and are unable to afford some medical services.
Citation: Boss EF, Niparko JK, Gaskin DJ, et al. Socioeconomic disparities for hearing-impaired children in the United States. Laryngoscope. 2011;121(4):860-866.
—Reviewed by Sue Pondrom