Hearing aid use increases among older Americans, but racial disparities persist

When you have untreated hearing loss, hearing aids can make all the difference in your quality of life, reducing your isolation and improving communication with loved ones. And, as research shows, wearing hearing aids is also good for your physical health.

Yet, hearing aids continue to be underused, hearing loss statistics show. Millions of Americans who could benefit from hearing aids never receive them, or wait for a very long time before finally buying them. Cost, access, and stigma are common reasons people do not wear hearing aids.

Hearing aid use is increasing

That's why, in a broad sense, it's good news that more older Americans are buying and wearing hearing aids, according to new data.

Specifically, between 2011 and 2018, hearing aid use increased from 15% to 18.5%, according to a nationally representative sample of adults older than 70. The research was published December 2020 in the medical journal JAMA: Internal Medicine.

For these people, this translates to less social isolation, better communication with loved ones, and a reduced risk of health conditions linked to untreated hearing loss. 

Hearing aid use not equal among socioeconomic groups

There was a concerning trend, though: Far fewer Black Americans reported an increase in owning and using hearing aids (a +.8% change in 7 years) compared with White Americans (a +4.3% change). 

And when looking at income levels, hearing aid ownership actually dropped in the past few years—from 12.4% to 10.8%—among older adults living at less than 100% of the federal poverty level. 

The study did not specifically examine hearing aid use among Hispanic older Americans, but separate studies have found a similar disparity when it comes to hearing care.

Why the treatment gap in hearing care?

This is a known treatment gap, and the new data affirms this problem is persisting rather than improving, particularly among the poorest Americans.

Systemic problems in U.S. healthcare mean minorities and lower-income Americans have less access to a range of audiology and hearing loss services, even if they have Medicare or Medicaid. (Hearing care is only partly covered by Medicare. Medicaid hearing care depends on your state's laws.) 

"Too often, preventive care is limited or nonexistent, hearing loss is underdiagnosed, and access to treatment is delayed or out of reach," said the authors of an editorial that accompanied a study examining hearing loss, dementia and heart disease among Hispanics.

A bright spot? A federal law passed in 2017 (that may go into effect in 2021) will mean that hearing aids will be available over-the-counter. This may help bring down costs and improve access for everyone. 

Similar disparities seen with cochlear implants

A 2021 study, conducted in Atlanta, found similar disparities when it came to cochlear implants. Cochlear implants are surgically implanted devices that are used when hearing aids are not adequate to address hearing loss.

Specficially, Black patients underwent cochlear implantation surgery at rates "disproportionately lower than expected based on local demographics." Also, compared to White and Asian patients, they had "significantly worse hearing at the time of cochlear implant referral." This means they were less likely to get beneficial hearing care, and when they did, their hearing was usually far worse, suggesting delayed access to treatment.

Efforts to expand hearing aid use

Untreated hearing loss is linked to negative physical and mental health changes, most notably dementia. And rates of dementia are expected to increase disproportionately among minorities in the U.S. in the next few decades.

Closing the gap in hearing care could be a pivotal way to stem this tide, particularly when caught early and addressed in mid-life, research indicates.

Oyendo Bien

How to do so? A lot more work is needed, but pilot projects offer glimpses of hope. One example: Oyendo Bien ("Hearing Well"), a program in Arizona that partnered with local community members to help increase culturally relevant communication about hearing loss. 

"The program’s 5 weekly group education sessions were facilitated by community health workers," explained University of Arizona associate professor Nicole Marrone, PhD, CCC-A, in the editorial mentioned above. These community workers bridge cultural and language gaps that make it harder to get help.

The project was successful and has received funding for expansion, leading to the newly created Hispanic Hearing Healthcare Access Coalition.

The project is more collaborative than traditional medicine. "Clinicians, scientists, scholars, and leaders must practice cultural humility to be responsive to community needs," she added. 

What can you do?

If you or a loved one has untreated hearing loss, the first step is to contact a hearing care provider in your area. They can walk you through the process, and if needed, recommend a hearing aid within your budget. They'll likely want to start with a hearing test, which is often covered by Medicare or Medicaid. Learn more about insurance and financial assistance for hearing aids.