Fostering nursery attendance and availability of a private outdoor area may protect young children living in household with smoking parents from environmental tobacco smoke.

Purpose Hearing loss is common and associated with reduced quality of life, particularly among elderly people. However, many patients do not use hearing aids. We evaluated the use of hearing aids among people with hearing loss by health services availability near their residence in a rural area in the state of Brandenburg, Germany. Methods Audiometry was performed in a convenience sample of subjects in ten towns and hearing loss was determined, defined as a threshold of ≥ 30 dB in at least one ear and at least one of the frequencies 0.5, 1.0, 2.0 and 4.0 kHz. For each participant, age and gender were collected and whether or not hearing aids were available. Results Among 186 persons with an average age of 74 years (interquartile range 71–81), 97% had hearing loss [95% confidence interval (CI) 95–100]. Among 121 patients with hearing loss who reported whether or not they have a hearing aid, 93 had no hearing aid (77%, 95% CI 69–84). The proportion of hearing-impaired persons who do not have a hearing aid significantly increased with the absence of a hearing aid specialist or ear nose throat (ENT) physician or both in the town where the tests were performed (p trend = 0.001). Conclusion Hearing loss is common among elderly people in the study area and many people in rural areas in Germany may not be properly supplied with hearing aids due to lack of hearing aid specialists and/or ENT physicians close to their residence. Interventions to improve this situation are urgently required.