The Toll of Hearing Loss is Global

A new study published in the prestigious medical journal The Lancet offers an unblinking look at the tremendous burden of hearing loss worldwide. “Global hearing health care: new findings and perspectives” was published on July 10th. The authors are Blake S. Wilson, Debara L. Tucci, Michael H. Merson and Gerard M. O’Donoghue. The first and fourth authors organized a three-day discussion at Duke University on the subject, which was followed by a massive review of the existing literature.images

Half a billion people have disabling hearing loss, a number that is far higher than earlier estimates. This is not just a little trouble hearing the TV, your wife mumbles, this restaurant is too noisy hearing loss. This is disabling hearing loss.

“Disabling” means that 500 million people worldwide cannot hear well enough to learn to speak (if they are children), with resulting lower literacy and lower quality of life. If they are adults, “disabling” means they may have a sense of profound isolation, typically withdrawing from community and family, prone to psychological illness and likely to develop earlier and more severe dementia than their peers. “Association is not causation,” as the authors remind us, and in fact causation is the subject of a number of ongoing research studies into the hearing loss/dementia link. But the numbers are alarming: “Indeed, the hazard ratio for developing dementia increases two, three, and five times with mild, moderate, and severe losses in hearing, respectively.”

Eighty percent of those with disabling hearing loss live in low and middle-income countries, and their hearing loss has severe economic and personal consequences. But those in wealthy countries are not immune to these consequences. “In high-income countries… adults with disabling hearing loss have twice the prevalence of unemployment and half the median income of their normally hearing peers.”

The answer, the authors say, is twofold: prevention and treatment. Prevention and treatment of childhood hearing loss would be most effective in poorer countries. Special attention to adults would be more effective in wealthier areas.

Prevention could reduce prevalence by 50 percent or more in some regions of the world, according to the World Health Organization. These preventive efforts include vaccinations against rubella, measles and mumps; education and treatment of HIV, syphilis, hypertension and other conditions. It also includes maternal nutrition and neonatal care, attention to ototoxic drugs, and and universal hearing screening of infants. Chronic or acute otitis media should be treated promptly with antibiotics.

Treatment costs could be reduced by strategies like more competition and lower prices for hearing devices, a change in service provision – and “with disruptive and parsimonious designs” of hearing aids and cochlear implants.

These parsimonious and disruptive designs include many of the solutions now being discussed in the United States: the use of personal amplification devices (PSAP’s), smartphone apps, elimination of the need for a physician’s clearance, revision of regulatory requirements to allow “more competition and comparison shopping for hearing aids.”

Sound familiar? That’s because these are the very same recommendations made by the National Academies of Sciences, Engineering, and Medicine in June 2016, and the earlier PCAST report to the President.

The report calls for a global initiative to reduce “the currently unbridled burden of hearing loss.” It cites the interagency partnership VISION 2020, which began in 1999 with a goal of reducing avoidable vision loss by 2019. Indeed, as the study points out, disabling hearing loss is almost twice as common as disabling vision loss. In the category of mild to complete loss, hearing loss outnumbers vision loss by 46.2 v. 24.5 million in years lived with disability. Hearing loss is the fourth leading cause of disability worldwide.

The report is complex and fascinating and if you are interested in reading the full report please contact me via the comments section on this blog.

And if you suspect you have hearing loss, be grateful that you live in a country where you may be able to find treatment at a reasonable cost. Over the counter hearing aids will not become a reality for several years, but in the meantime get a hearing aid if you can afford it, try Costco or good online retailers for lower prices, get a PSAP if you can’t afford a hearing aid, try out some smart phone apps. But don’t ignore it.

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For more information about living with hearing loss, read my book “Shouting Won’t Help: Why I and 50 Million Other Americans Can’t Hear You. 

9 thoughts on “The Toll of Hearing Loss is Global

  1. Thanks Katherine!
    This news is both fascinating and frightening
    Fascinating because it highlights the it acknowledges the frequency of hearing loss and frightening because so much more needs to be done to improve care for people who can’t hear. I agree 100% with your advice about getting aids, PSPs or an assistive listening system.

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  2. Thanks Katherine!
    This news is both fascinating and frightening
    Fascinating because it highlights the unacknowledgesd frequency of hearing loss and frightening because so much more needs to be done to improve care for people who can’t hear. I agree 100% with your advice about getting aids, PSPs or an assistive listening system.

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  3. Thanks Katherine. The information we have available now is fascinating. Because I go back such a long way with SHHH/HLAA, I well remember how difficult it was to access information, three and even 2 decades ago! There were very few books, very few research programs that looked beyond total and cultural deafness, and no studies on how hearing loss affects people with hearing loss beyond hearing factor itself. I will appreciate receiving a copy or link to the global study you refer to. Thank you. Julie Olson, past chair SHHH National Board of Trustees 1995 – 1997. (Long time ago, but still active!)

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    • Yes, it is amazing. And it’s not just that we have the internet. The information literally was not available before. People still give widely varying figures for the number of Americans with hearing loss. I always say 48 million because that’s what a good Hopkins study said. The NIDCD still goes with 36 million (I think) but that’s based on self report. I just emailed you the study.

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      • Thank you. LOL. The first thing I learned in a graduate school statistics class was that a hypothesis could easily determine the resulting statistical analysis for a particular study. In other words, it’s easy to manipulate data. Seriously, we all know that hearing loss is far more prevalent than people realize. If the hard of hearing population would ‘destigmatize’ and demand more research, we’d see even more good things happen. Just think of all those people demanding better care and technology! My other bandwagon stance is finding a way to get medical professionals, including hearing healthcare professionals to understand the psycho social issues involved. IMHO Audiology practices should be hiring hard of hearing specialists to conduct hearing aid/hearing loss orientation programs in their offices. When one accesses current research on the co-morbidities related to hearing loss it validates this need. And, of course, adult onset hearing loss has unique variables. Fascinating stuff.

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  4. Thank you Katherine. I can’t tell you how much your writing and research has helped me over time. This report is daunting and am so glad we have it. I am always seeking more information. I wish more studies were done on the effects of hearing loss and the neurobiology of the brain.
    Would you please send me a copy of the full report. Thank you so much!
    Betsy Donahue

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