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Addressing Hearing Loss With an Aging Population

Goman, Adele M. PhD

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doi: 10.1097/01.HJ.0000520662.11199.72
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Adele M. Goman, PhD

When addressing hearing loss from a public health standpoint, it is important that we not only consider the needs of today but also plan for the needs of the future by taking into account the fact that our population is both increasing and aging. The prevalence of hearing loss increases with age, and today nearly two-thirds of older adults are estimated to have better-ear hearing loss (Am J Public Health. 2016;106[10]:1820 Despite this high prevalence, many people are not utilizing devices or services for hearing loss (Arch Intern Med. 2012;172[3]:292 This low uptake could be underpinned by a number of factors—a lack of understanding and awareness of hearing loss and the available technologies and services, high costs of devices and services, the utility and design of existing technologies for hearing loss, and limited access to hearing health care. Estimating the prevalence of hearing loss is pivotal to inform researchers, clinicians, and policymakers in planning for and addressing societal hearing health care needs.

My colleagues and I recently estimated the number of adults in the United States who will have hearing loss if the current prevalence of hearing loss across different age groups does not change (JAMA Otolaryngol Head Neck Surg. 2017 We previously estimated the prevalence of hearing loss across different age groups using audiometric data from the National Health and Nutritional Examination Survey (Am J Public Health, 2016 We used these estimates and applied them to U.S. population projections to explore how the number of people with hearing loss across different age groups will change over time. Although the number of adults with hearing loss is expected to increase across all age groups due to the growing population, the increase will be most noticeable among older adults because of the ongoing distributional shift toward older adults in the population. In our research letter, we highlighted that by 2020, 44 million U.S. adults over the age of 20 are expected to have better-ear hearing loss (JAMA Otolaryngol Head Neck Surg. 2017 However, this number is predicted to rise to over 73 million in 2060. Strikingly, there will be more adults over the age of 70 with better-ear hearing loss by 2060 than there are adults over 20 with better-ear hearing loss today.

Current services are neither set up nor prepared to cope with this potential demand. In addition to best practice audiology services, the increased need for affordable interventions and access to trained hearing specialists will require novel and cost-effective approaches to hearing health care such as community health care workers, telehealth models, and the use of consumer technology. The National Academies of Sciences, Engineering and Medicine report on hearing health care for adults proposed a number of recommendations to improve hearing health care access and affordability; it's important that these recommendations are considered in the context of the anticipated rise of the adult population with hearing loss (NASEM, 2016 Society and policymakers must prepare for the increasing impact of hearing loss, particularly among older adults, by investing in public education about hearing loss and professional training initiatives, and by addressing the financial barriers to hearing interventions and services.

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