Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years

Abstract

IMPORTANCE As the American population ages, effective healthcare planning requires understanding changes in hearing loss prevalence. OBJECTIVE Determine if age- and sex-specific prevalence of adult hearing loss changed during the past decade. DESIGN Analysis of 2011–2012 National Health and Nutrition Examination Survey (NHANES) audiometric data compared to NHANES 1999–2004. NHANES is a cross-sectional, nationally-representative interview and examination survey of the civilian, non-institutionalized population. PARTICIPANTS A stratified random sample of 3,831 adults aged 20–69 years INTERVENTIONS Audiometry and questionnaires MAIN OUTCOMES AND MEASURES Speech-frequency hearing impairment (HI) defined by pure-tone average (PTA) of thresholds across 0.5–1–2–4 kHz greater than 25 dB hearing level (HL); high-frequency HI defined by PTA across 3–4–6 kHz >25 dB HL. Logistic regression was used to examine unadjusted, age- and sex-adjusted, and multivariable-adjusted associations with demographic, noise exposure, and cardiovascular risk factors. RESULTS The 2011–2012 unadjusted adult prevalence of unilateral and bilateral speech-frequency HI was 14.1%, compared to 16% for 1999–2004; after age- and sex-adjustment, the difference was significant, odds ratio (OR)=0.70 (95% confidence interval [95% CI]: 0.56–0.86). Men had nearly twice the prevalence of speech-frequency HI, 18.6% (17.8 million), compared to women, 9.6% (9.7 million). For 60–69 year-olds, speech-frequency HI prevalence was 39.3% (95% CI: 30.7%–48.7%). In multivariable analyses for bilateral speech-frequency HI, age was the major risk factor; however, men, non-Hispanic (NH) white and NH Asian race, lower educational attainment, and heavy use of firearms all had significant associations. Additional associations for high-frequency HI were Mexican-American and Other Hispanic race/ethnicity and the combination of loud and very loud noise exposure occupationally and outside of work, OR=2.4 (95% CI: 1.4–4.2). CONCLUSIONS AND RELEVANCE Adult hearing loss is common and strongly associated with age and other demographic factors (sex, race/ethnicity, education). Noise exposure, which is preventable, was less strongly associated. Cardiovascular risk factors – heavy smoking, hypertension, and diabetes – were significant only in unadjusted analyses. Age- and sex-specific HI prevalence continues to decline. Despite the benefit of delayed onset of HI, hearing healthcare needs will increase as the U.S. population grows and ages.

Narratives of identity: understanding the experiences of adults with hearing loss who use hearing aids

“…The present study is also limited as a result of a participant sample that lacks diversity and, therefore, limits our ability to apply the identities across all individuals seeking hearing healthcare services. The study sample includes primarily White individuals, which is not representative of the deaf and hard-ofhearing community across the U.S. and elsewhere (Hoffman et al 2017) and socioeconomic status was not noted during the study. It is likely that one's ethnicity, culture, and socioeconomic status all play a large part in both one's identity and whether or not one can even consider purchasing HAs, let alone adhering to recommended, daily use (Nieman et al 2016).…”

Effects in Hearing Thresholds in Subjects Receiving Radiotherapy as Treatment for Head and Neck Cancer

“…Study of hearing loss prevalence evinced that the difference between gender had been declining. However it is worth emphasizing that men's habits are more associated with exposure to noise than women [22].…”

Kids Nowadays Hear Better Than We Did: Declining Prevalence of Hearing Loss in US Youth, 1966–2010

“…If hazardous recreational exposure to loud music has been increasing, one might expect a parallel increase in the population prevalence of hearing loss. Previous analyses of audiometric surveys of US adults have shown that hearing thresholds, especially in higher frequencies, have actually improved since 1960 . Possible reasons include loss of manufacturing jobs and greater use of hearing protection in noisy workplaces.…”

“…Previous analyses of audiometric surveys of US adults have shown that hearing thresholds, especially in higher frequencies, have actually improved since 1960. [9][10][11] Possible reasons include loss of manufacturing jobs and greater use of hearing protection in noisy workplaces. However, PMP use begins in childhood; effects of excessive exposure might best be seen in surveys of older children and adolescents, for whom occupational noise exposure might not be an important risk factor.…”