Hearing aid use is significantly low among Hispanics/Latinos in the United States with clinically significant hearing loss, finds a new study. Data on 1,989 Hispanic/Latino older adults with hearing loss showed that only 87 (4.7 %) used hearing aids—lower than what the researchers expected and lower than the already-low national estimate of hearing aid prevalence at 14.2 to 33.1 percent. Access to health insurance was found to play an important role in the adults' hearing aid use.
"The most significant finding was that health insurance was associated with greater odds of hearing aid use," said lead author Michelle L. Arnold, AuD, PhD, of the University of South Florida Sarasota. "This isn't too surprising though. Many previous studies also point to a lack of affordability and access being major barriers to hearing health care."
The participants were also given the Short Acculturation Scale for Hispanics (SASH) to assess their language use, media, and ethnic and social relations. The SASH scores suggested that the study participants tended to think and speak in Spanish and preferred social contacts from Hispanic/Latino backgrounds. While the SASH language scores did not significantly characterize hearing aid use, the researchers noted that language may have a secondary effect on the participants' overall health care access, including access to insurance.
"Anecdotally, I've noted that language barriers are a significant problem," Arnold told The Hearing Journal. "Even clinics that are located in areas with high concentrations of Spanish-speakers often don't provide culturally and linguistically appropriate services—whether that is having a translator available or documents translated into Spanish."
"It's odd to me when patients are referred from an outside provider, and they come in with instructions that this provider gave them that are in English, when it is clear that they don't speak English, let alone read it," Arnold cited from her experience. "These types of behavior from health care providers perpetuate health inequities. And they are unacceptable when you know that a linguistic minority resides in your practice location's geographic area."
When asked about the practical steps for hearing health care providers to help improve hearing aid use in this population, Arnold offered several ideas.
"First, if you are a health care provider who works in an area where you KNOW you will see people from a different cultural or linguistic background, do your due diligence to provide culturally and linguistically appropriate services to the best of your capabilities," Arnold noted. "Make noise if there aren't interpreters or translators available, make noise if materials in languages commonly spoken in your community aren't available. Do what you can to pressure administrators and the system to change, even if it's just for your individual clinic schedule. Don't perpetuate health inequities because 'this is the way we've always done it'."
"Second, addressing the under-utilization of hearing health care among people with hearing loss is a huge issue," she added. "Demographically, we are getting older and more diverse in the United States," she pointed. The prevalence of clinically significant hearing loss is more than 50 percent among adults aged 65 years and older, and 80 percent among older adults between 75 and 80 years old. Hearing loss is associated with various negative outcomes that impact cost, general health—such as increased risk of falls, hospitalizations, mental health problems, and dementia—and overall quality of life. Arnold posed: "If you can't have a conversation, how good is your quality of life going to be?"
The authors stressed the need to change public health policy and clinical service provision to improve access to hearing care for this patient population. "We need to start taking a serious look at whether addressing untreated hearing loss can mitigate some of these other health conditions," Arnold added. "Part of that includes addressing the differential needs of people in the United States from culturally and linguistically diverse backgrounds."