By Shane Tagupa
Adults who have concurrent vision and hearing impairment or dual sensory impairment (DSI) are less likely to be part of the workforce, a recent study finds.
"American adults with dual sensory impairment had 40 percent lower odds of employment, while those with vision or hearing impairment alone had about 20 percent lower odds of employment when compared to American adults without either sensory impairment," said Varshini Varadaraj, MD, and Bonnielin K. Swenor, PhD, two of the study authors of the research letter, "Trends in Employment by Dual Sensory Impairment Status."
"While prior research has reported lower employment rates among individuals with either hearing or vision impairments, studies have not examined those with dual sensory impairment (that is, concurrent vision impairment and hearing impairment), a group that may be at increased risk for unemployment," Varadaraj and Swenor told The Hearing Journal.
UNEMPLOYMENT & DISABILITY
The authors examined data from the National Health Interview Survey (NHIS) from 2008 to 2017, and included those from 277, 251 participants aged 18 to 75 years old, who had no sensory impairment, a visual impairment only, a hearing impairment only, and those with dual impairment.
The majority (61 percent) of participants with DSI reported that they were unemployed. Of these, 51 percent claimed that the reason for their unemployment was that they had a disability. In comparison, only 46 percent of visually impaired participants and 44 percent of hearing-impaired participants were unemployed.
"This corroborates evidence from previous studies that have shown lower employment rates among those with sensory impairments, possibly because they face greater difficulties entering or remaining in the workforce," the authors reported. "Individuals with DSI may be especially susceptible given an inability to rely on sensory substitution to overcome impairment."
While this study provides an important glimpse into the employment vulnerability of adults with DSI, it also comes with notable limitations.
"First, these data estimate functional sensory impairment and are based on participant self-report, which likely are underreported, and therefore the observed associations between impairment and employment are likely underestimates," said Varadaraj and Swenor, who are both from the Wilmer Eye Institute at Johns Hopkins University School of Medicine.
"Second, the NHIS study population does not include persons on active duty with the Armed Forces, and therefore our results are not generalizable to that specific population."
Regarding the study's data collection via self-reporting, the researchers asked questions that were "informed by established biopsychosocial models of disability (rather than the medical model) that take into account features of the person and the overall context in which the person lives."
"The biopsychosocial model from the International Classification of Functioning, Disability, and Health (ICF) by the World Health Organization integrates medical and social perspectives of health," Varadaraj and Swenor explained.
"There is value in examining self-reported impairments as experienced by the individual as well as for future studies to examine objective measures (visual acuity, pure tone audiometry, etc.) to allow for clinically meaningful definitions of impairment that can be compared across studies."
SUPPORTING THE DEAFBLIND IN THE WORKPLACE
Noting the marked association between health and productivity as shown by previous studies, the authors are hopeful that their analysis could help spark a national discussion on the employment of people with DSI.
"To our knowledge, this is the first description of DSI and employment in a nationally representative population and highlights the need for understanding barriers for employment in people with DSI, focusing on strategies for engaging them, and addressing their specific needs in the workforce."
A previous analysis from the Disability Statistics Annual Report based on the American community "only captures the most severe impairment and… fails to present data on those with dual sensory impairment," said the authors.
Their study also suggests that people with sensory impairments may benefit from further research on improved access to eyeglasses, use of hearing aids, use of low-vision rehabilitation, and integration of vision and hearing interventions.
When asked specifically about the role of hearing aids among the study participants, Varadaraj and Swenor told The Hearing Journal that they did not examine this in their study. "However, the National Health Interview Survey does include a question for participants on whether they currently use hearing aids, to which only 1.8 percent (weighted estimate among adults 18-75 years from years 2008 to 2017) answered in the affirmative."
"With the aging of the U.S. population, the number of people with DSI is expected to increase, magnifying the public health significance of this subset."