We know there are differences in hearing aid use by race, ethnicity, and income among older adults with hearing loss, with a lower prevalence of hearing aid use among minority older adults. —Carrie Nieman, MD, MPH
Explore This IssueMay 2021
“But these numbers do not translate to hearing aid use,” Dr. Nieman cautioned. “We know there are differences in hearing aid use by race, ethnicity, and income among older adults with hearing loss, with a lower prevalence of hearing aid use among minority older adults (J Aging Health. 2016;28:68-94) as well as low-income older adults (J Health Care Poor Underserved. 2016;27:1812–1818).”
The Impact of Undiagnosed and Untreated Hearing Loss
Hearing loss can affect both children and adults in profound ways. Undiagnosed and untreated hearing loss can negatively impact communication and social development in children and occupational opportunities and success in adults, Dr. Bush said. Emotional health and wellbeing are impacted by hearing loss, as is the ability to interact with people on a daily basis and feel a sense of community. Adults with hearing loss may become isolated and limit their social exposure and interactions due to fear or embarrassment of missing something in a conversation.
Dr. McGrath said that underdetection and undertreatment of hearing loss in people across a lifespan is disheartening in light of repeated evidence that hearing loss management improves quality of life and public health enterprises. Children with unmanaged hearing loss are at a higher risk for decreased academic success, resulting in a higher likelihood of low educational attainment, unemployment, and low-income status (Otol Neurotol. 2015;36:545-550). According to the CDC, the lifetime medical, educational, and occupational costs resulting from children in the United States who are born with hearing loss are estimated at $2.1 billion (MMWR Morb Mortal Wkly Rep. 2004;53:57-59).
On the other end of the age spectrum, adults with untreated hearing loss have a greater lifetime history of hospitalization, reduced productivity in society, a higher risk of disability, and a higher mortality rate, Dr. McGrath said. Studies have shown that these adult populations with hearing loss have higher incidences of comorbid medical conditions and exposure to adverse environmental conditions associated with hearing loss (Vital Health Stat. 1997;10(194)). The total economic costs associated with adult-onset hearing loss are estimated to be between $1.8 and $194 billion, including the estimated $12.8 billion associated with excess medical costs (JAMA. 2017;143:1040-1048). The economic costs related to adult-onset hearing loss can be inferred to be on the higher end of the range in economically suppressed areas.
Individuals with untreated hearing loss also accrue higher healthcare use, costing more than $20,000 more than those without hearing loss over a 10-year period (JAMA Otolaryngol Head Neck Surg. 2019;145:27-34). On an individual level, hearing loss has been linked to increased rates of social isolation, mental health difficulties, dementia, and cognitive decline, Dr. Alyono said.