The Impact of Hearing Loss on Health Care Access During the COVID‐19 Pandemic

Huang, Yiqing; Joo, Hyonoo; Schoo, Desi P.; Agrawal, Yuri; Chen, Jenny

doi:10.1002/ohn.362

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…Participants with ADL or communication disabilities experienced the greatest number of barriers, with as many as three-quarters experiencing 3 or more barriers in the past 3 years, suggesting that these groups may require the most support. The preponderance of access barriers experienced was consistent with that in other studies that found disparities in general health care access for people with disabilities . Thus, disparities in gynecological cancer screenings and contraceptive use may be due to structural barriers to care.…”

Section: Discussionsupporting

confidence: 86%

“…The preponderance of access barriers experienced was consistent with that in other studies that found disparities in general health care access for people with disabilities. 32 , 33 , 34 Thus, disparities in gynecological cancer screenings and contraceptive use may be due to structural barriers to care. Future research needs to examine access to other RH services, such as screening for sexually transmitted infections (STIs) and abortion care, which were not examined in this study, although we did find that people with disabilities are more likely to consider SMA than people without disabilities.…”

Section: Discussionmentioning

confidence: 99%

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Access to Reproductive Health Services Among People With Disabilities

Biggs,

Schroeder,

Casebolt

et al. 2023

JAMA Netw Open

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ImportancePeople with disabilities face inequitable access to reproductive health (RH) services, yet the national prevalence of barriers to access experienced across disability types and statuses is unknown.ObjectiveTo assess the national prevalence of barriers to RH access experienced by people with disabilities.Design, Setting, and ParticipantsThis cross-sectional study analyzed results of an online probability-based national survey of RH experiences that was conducted from December 2021 to January 2022. The national sample consisted of English- and Spanish-speaking panel members of a market research firm. Panelists were invited to participate in a survey on their RH experiences and opinions. These participants were aged 15 to 49 years and assigned female at birth (AFAB). Weighted proportions were estimated, and bivariable and multivariable regression analyses were performed to assess associations between disability status and barriers to accessing RH services.ExposureUsing 5 of the 6 Washington Group Short Set on Functioning items, 8 dichotomous disability indicators were created: (1) vision, (2) hearing, (3) mobility, (4) activities of daily living, (5) communication, (6) overall disability status (a lot or more difficulty functioning in ≥1 domain), (7) some difficulty functioning (below the disability threshold; some or more difficulty functioning in ≥1 domain), and (8) multiple disabilities (a lot or more difficulty functioning in ≥2 domains).Main Outcomes and MeasuresNumber and types of barriers (logistical, access, cost, privacy, and interpersonal relationship) to accessing RH services in the past 3 years.ResultsAfter exclusion, the final sample included 6956 people AFAB, with a mean (SD) age of 36.0 (8.3) years. Of these participants, 8.5% (95% CI, 7.6%-9.5%) met the disability threshold. Participants with disabilities compared with those without disabilities were disproportionately more likely to be non-Hispanic Black (18.8% [95% CI, 14.4%-24.1%] vs 13.2% [95% CI, 11.9%-14.5%]) or Hispanic or Latinx (completed survey in English: 18.1% [95% CI, 14.0%-23.0%] vs 14.6% [95% CI, 13.3%-16.0%]; completed survey in Spanish: 8.9% [95% CI, 6.2%-12.8%] vs 6.2% [95% CI, 5.4%-7.1%]) individuals, to identify as LGBTQAI (lesbian, gay, bisexual, transgender, queer [or questioning], asexual [or allied], intersex; 16.4% [95% CI, 12.3%-21.6%] vs 11.8% [95% CI, 10.6%-13.1%]), to live below the federal poverty level (27.3% [95% CI, 22.3%-32.8%] vs 10.7% [95% CI, 9.7%-11.9%]), and to ever experienced medical mistreatment (49.6% [95% CI, 43.7%-55.5%] vs 36.5% [95% CI, 34.8%-38.2%]). Among those who had ever tried to access RH services (n = 6027), people with disabilities vs without disabilities were more likely to experience barriers (69.0% [95% CI, 62.9%-74.5%] vs 43.0% [95% CI, 41.2%-44.9%]), which were most often logistical (50.7%; 95% CI, 44.2%-57.2%) and access (49.9%; 95% CI, 43.4%-56.4%) barriers. The disability domains with the highest proportion of people who experienced 3 or more barriers in the past 3 years included activities of daily living (75.3%; 95% CI, 61.1%-85.6%), communication (65.1%; 95% CI, 49.5%-78.1%), and multiple (59.9%; 95% CI, 45.6%-72.7%) disabilities.Conclusions and RelevanceThis cross-sectional study found large disparities in access to RH services among people AFAB with disabilities. Findings indicated a need to alleviate barriers to RH care, including improving the transportation infrastructure and reinforcing patient-centered approaches that engender inclusivity in health care settings.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Access to Reproductive Health Services Among People With Disabilities

Biggs,

Schroeder,

Casebolt

et al. 2023

JAMA Netw Open

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“…[2][3][4] Multiple studies have found that hearing loss may adversely affect mobility and increase the risk of falls in the elderly, [5][6][7][8] which may in turn lead to poor outcomes such as decreased access to health care and increased mortality. 9,10 Limited physical mobility is common for patients of all ages in the United States 11 and is associated with poor performance of daily activities, depressive symptoms, and diminished quality of life. [11][12][13] The association between hearing health and physical mobility remains under investigation, particularly among younger adults as there have been no large-scale studies of this association that have included US adults of all ages.…”

mentioning

confidence: 99%

“…From a public health perspective, hearing loss is a modifiable risk factor for several adverse outcomes through the use of hearing aids or other hearing augmentation devices 2‐4 . Multiple studies have found that hearing loss may adversely affect mobility and increase the risk of falls in the elderly, 5‐8 which may in turn lead to poor outcomes such as decreased access to health care and increased mortality 9,10 . Limited physical mobility is common for patients of all ages in the United States 11 and is associated with poor performance of daily activities, depressive symptoms, and diminished quality of life 11‐13 …”

mentioning

confidence: 99%

Association Between Hearing Difficulty and Mobility in Adults of All Ages: National Health Interview Survey

Joo,

Huang,

Schoo

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveTo investigate the relationship between hearing difficulty and measures of mobility for US adults.Study DesignCross‐sectional study.Setting2021 National Health Interview Survey.MethodsThe survey asked US adults about hearing difficulty and mobility measures, including difficulty walking 100 yards, difficulty climbing 12 steps, and injury from falling within the past 3 months. Multivariable logistic regressions examined the associations between hearing and mobility outcomes, controlling for visual difficulty, medical comorbidities, and various demographic characteristics (age [18‐39, 40‐64, 65+], race/ethnicity, sex, socioeconomic status).ResultsThe 2021 NHIS surveyed 29,467 adults, representing 253 million people in weighted responses (52% female; mean age 48.3, standard deviation = 18.6). Controlling for covariates, hearing difficulty was associated with increased odds of difficulty walking 100 yards (odds ratio, OR = 1.47, P < .001), difficulty climbing stairs (OR = 1.62, P < .001), and injury from falling in the past 3 months (OR = 1.51, P < .001). There was a significant interaction between age and hearing difficulty for injurious falls; stratifying by age revealed that younger adults (ages 18‐39) with hearing difficulty were more likely to report recent harmful falls than their normal hearing peers; this increased risk was greater in magnitude than that observed comparing older adults with and without hearing difficulty.ConclusionThe hearing difficulty is associated with worsened mobility for US adults and may be a stronger independent predictor of injury from falls for younger adults as compared to older adults. These findings can inform interventions to reduce the burden of declining mobility in adults with hearing difficulty.

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Factors Associated With Psychological Distress Among Thyroid Cancer Patients

Lin,

Wei,

Finegersh

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo assess the prevalence of psychological distress (PD) among thyroid cancer patients (TCPs) and identify clinical, demographic, and socioeconomic factors associated with PD.Study DesignRetrospective population‐based cohort study.Setting2016 to 2018 National Health Interview Survey.MethodsAdults with cancer were included. The primary outcome measure was moderate‐to‐severe psychological distress (MSPD), defined as a respondent score ≥5 on the validated K6 Psychological Distress Scale. χ2 tests were used to assess differences in MSPD by cancer type. Weighted multivariable logistic regression was used to elucidate factors associated with MSPD among TCPs.ResultsThe majority of TCPs (n = 684,674) were white (75.4%), female (78.5%), and on average 55.65 years old (SD = 13.2). 28.4% reported MSPD. On weighted analysis, TCPs were more likely to have MSPD than prostate (14.9%, P < .001), bladder (16.4%, P = .011), and nonmelanoma skin cancer (16.3%, P < .001) patients but less likely than pancreatic cancer (30.0%, P = .030) patients. TCPs who were older when surveyed (odds ratio [OR], 0.93; 95% confidence interval [CI, 0.88‐0.98), previously drank alcohol (OR, 0.23; 95% CI, 0.06‐0.91), and saw a general physician (GP) in the past year (OR, 0.14; 95% CI, 0.03‐0.56) were less likely to have MSPD. Female sex (OR, 8.12; 95% CI, 1.61‐40.89), increased number of medical comorbidities (OR, 1.46; 95% CI, 1.00‐2.14), and functional limitations (OR, 4.55; 95% CI, 1.33‐15.74) were associated with increased likelihood of MSPD.ConclusionNearly 30% of TCPs have MSPD, especially younger patients who do not regularly see GPs. Future work to identify the most at‐risk patients is needed to improve prevention and develop meaningful psychosocial interventions.

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The Impact of Hearing Loss on Health Care Access During the COVID‐19 Pandemic

Cited by 6 publications

References 9 publications

Access to Reproductive Health Services Among People With Disabilities

Access to Reproductive Health Services Among People With Disabilities

Association Between Hearing Difficulty and Mobility in Adults of All Ages: National Health Interview Survey

Factors Associated With Psychological Distress Among Thyroid Cancer Patients

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