Overall Increase in Hearing Aid Ownership
From 2011 to 2018, data from the National Health Aging and Trends Study (NHATS) showed a gradual rise in hearing aid ownership and use among U.S. adults aged 70 and older. Starting at 15.0% in 2011, the proportion of seniors using these devices climbed to 16.9% by 2015 and reached 18.5% in 2018. This overall increase signals growing adoption, but it's crucial to examine the nuances within this trend to understand which populations benefited most during this period.
Disparities by Race and Gender
One of the most notable findings during this period was the significant disparity in ownership and use among different racial and gender groups. The data showed that fewer Black Americans owned and used hearing aids compared to White Americans throughout the entire study period. This gap did not close, with White Americans seeing a substantial 4.3% increase in ownership, while Black Americans experienced a much smaller 0.8% rise.
Furthermore, gender played a significant role within these racial groups. White men experienced a remarkable 28.7% increase in hearing aid use, demonstrating the strongest growth across all subgroups. In stark contrast, Black women saw the smallest growth, with only a 5.8% increase over the same eight-year period. These findings highlight deep-seated inequities in hearing healthcare access and utilization that likely stem from historical, socioeconomic, and systemic factors.
Impact of Socioeconomic Status
Income level was a powerful predictor of hearing aid ownership, and this trend widened between 2011 and 2018. Older adults living at less than 100% of the federal poverty level actually experienced a decrease in hearing aid ownership, falling from 12.4% in 2011 to 10.8% in 2018. This suggests that low-income seniors faced increasing financial barriers during this time, possibly struggling with the high costs associated with hearing aids and audiologist services.
Conversely, seniors with higher incomes saw their ownership rates increase. For older adults living at or above 200% of the poverty line, ownership rose from 16.4% in 2011 to 21.2% in 2018. This stark contrast underscores how financial resources enable access to necessary medical devices, widening the gap in hearing health outcomes based on wealth.
Age and Hearing Aid Adoption
As expected, the study also found that the proportion of older adults who owned hearing aids increased with age. This is a consistent trend across many studies and reflects the progressive nature of age-related hearing loss. However, even within older age brackets, the demographic and socioeconomic factors mentioned above still influence who ultimately obtains and uses a hearing aid.
Factors Influencing Adoption and Non-Adoption
Beyond the demographic trends, several other factors influence a senior's decision to adopt a hearing aid. Understanding these is key to addressing the persistent disparities.
- Perceived Need: Many seniors underestimate their hearing loss or feel their hearing is adequate for their needs, delaying or forgoing hearing aid adoption. This is a major barrier, often requiring intervention from family members or healthcare professionals.
- Financial Constraints: For a significant portion of non-adopters, cost is the primary barrier. With hearing aids often not covered by Medicare or standard insurance plans during this period, the out-of-pocket expenses were prohibitive for many.
- Stigma: Societal stigma associated with hearing aids—the perception of being 'old' or 'handicapped'—persists as a barrier for some individuals, though its impact may be decreasing.
- Discomfort and Lack of Perceived Benefit: Some users reject or stop using hearing aids due to physical discomfort or a perceived lack of significant benefit. Proper fitting and counseling are essential to overcome this hurdle.
Comparative Analysis of Ownership Trends
| Demographic Group | 2011 Ownership | 2018 Ownership | Change | Key Insight |
|---|---|---|---|---|
| Overall (70+ years) | 15.0% | 18.5% | +3.5% | Consistent upward trend overall. |
| Black Americans | <15.0% | Small increase | +0.8% | Lagging growth compared to White Americans. |
| White Americans | <15.0% | Higher increase | +4.3% | Significant growth, especially among men. |
| White Men | Lower than total | Highest subgroup | +28.7% increase in use | Largest growth observed. |
| Black Women | Lowest subgroup | Very small increase | +5.8% increase in use | Smallest growth, persistent low rates. |
| Below 100% FPL | 12.4% | 10.8% | -1.6% | Ownership decreased, indicating financial barriers. |
| 200%+ FPL | 16.4% | 21.2% | +4.8% | Ownership increased, showing correlation with wealth. |
The Evolving Landscape of Hearing Care
The trends observed from 2011 to 2018 set the stage for further developments in the hearing care industry. The data revealed a persistent access gap related to race and income, highlighting areas for policy improvement. Since this period, notably, the Over-the-Counter Hearing Aid Act of 2017 was fully implemented, a move that could significantly alter future trends by lowering costs and increasing accessibility. Researchers and policymakers will continue to monitor how these changes impact demographic and socioeconomic disparities moving forward.
Conclusion
While the period between 2011 and 2018 saw a positive increase in overall hearing aid ownership among older adults in the U.S., the data reveals a complex reality of demographic and socioeconomic inequality. The largest gains were concentrated among wealthier and White populations, while low-income seniors and Black Americans experienced far less, or even declining, ownership. These findings emphasize the importance of addressing systemic barriers to hearing healthcare and the need for ongoing efforts to ensure equitable access to assistive technology for all seniors.
For more detailed research on this topic, a comprehensive study was published in JAMA Internal Medicine: Trends in Hearing Aid Ownership Among Older Adults in the United States, 2011-2018.
