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Hearing Aid Use Among Older U.S. Adults: The National Health and Nutrition Examination Survey, 2005–2006 and 2009–2010

Bainbridge, Kathleen E.1; Ramachandran, Virginia2

doi: 10.1097/01.aud.0000441036.40169.29
Research Articles

Objectives: The authors estimated the proportion of older adults in the United States who report hearing aid use among those likely to benefit. To more fully understand what factors underlie the low proportion of hearing aid use, the authors examined a variety of socio-demographic correlates as well as measures of health care access and insurance status in relation to hearing aid use among potential hearing aid candidates.

Design: The study makes use of cross-sectional data collected during 2005–2006 and 2009–2010 as part of the National Health and Nutrition Examination Survey. The 1636 adults aged 70 years and older were selected by using a complex sampling design and comprise a nationally representative sample. In addition to self-reported hearing aid use, data on pure-tone thresholds, perceived hearing ability, place for routine health care, time since last hearing test, type of insurance coverage, and socio-demographic characteristics including age, sex, race/ethnicity, family size, and income-to-poverty ratio were collected. The analytical sample consisted of 601 adults who had a better-ear pure-tone average of ≥35 dB HL at 500, 1000, and 2000 Hz or who reported moderate or worse hearing ability.

Results: One third of the potential hearing aid candidates reported current use of hearing aids. The authors observed a 28 to 66% greater prevalence of hearing aid use among older adults in the upper four fifths of the income-to-poverty distribution compared with those in the bottom one fifth. Compared with people who had their hearing tested 5 to 9 years ago, those with more recent hearing tests were more than two to three times as likely to be a current hearing aid user. No differences were observed by age after adjusting for pure-tone average and no differences were observed by sex after adjusting for perceived hearing ability. No differences were observed by place of routine health care or by type of insurance coverage.

Conclusions: Use of hearing aids is low among older adults who might benefit. Identifying and surmounting barriers to hearing aid use, especially among low-income adults, remains an important objective for hearing health care in the United States.

Cross-sectional data collected as part of the National Health and Nutrition Examination Survey were used to estimate associations between socio-economic factors, health care use, and health insurance provider and hearing aid use among adults age 70 years and older. Data on self-reported hearing aid use, pure-tone thresholds, self-perceived hearing ability, place for routine health care, time since last hearing test, type of health insurance, age, sex, race, and income-to-poverty ratio were analyzed in a sample of 601 potential hearing aid candidates. Only one third of the sample reported current use of hearing aids. Factors associated with hearing aid use included recent hearing test and higher income-to-poverty ratio.

1National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, USA; and 2Department of Otolaryngology—Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan, USA.

The views expressed in this report represent those of the authors and do not necessarily represent the agencies or institutions for which they work.

The authors declare no other conflict of interest.

Address for correspondence: Kathleen E. Bainbridge, National Institute on Deafness and Other Communication Disorders, 6001 Executive Boulevard, Room 8327, MSC 9670, Bethesda, MD 20892, USA. E-mail:

© 2014 by Lippincott Williams & Wilkins