Last week, June 23-25, HLAA held its first in-person national Convention since June 2019. I had forgotten how great it is to see old friends and meet new people with hearing loss. The presentations were excellent, and attendance seemed impressive.
The convention was held in Tampa, Fla, at a nice Marriott by the waterfront. I left the hotel only once, knocked flat by the heat and humidity. Amusingly, for such a steamy city, the Stanley Cup playoffs were going on right next door, with Tampa Bay in the finals. Many readers may remember when ice hockey was a winter sport.
Due to flight delays, I missed the open board meeting and the opening session. But as I went up in the elevator, slightly dazed from the difficult travel day, I got into conversation with a convention attendee who encouraged me to come to the welcome party and even showed me the way. (Convention hotels are always confusing when you first arrive.) Right away I could see that this was a Convention with a difference. Attendees were far more diverse than at previous conventions, and this diversity was reflected in the programming as well. Or maybe the programming resulted in the diversity.
The Friday morning research symposium reflected that diversity. Christine Dinh, MD, from the University of Miami, Candace Hobson, M.D., from Emory University, Diane Martinez, AuD, University of South Florida, and Justin Golub, MD, Columbia University (and one of our New York City Chapter’s professional advisors), made up the panel. They talked a bit about new developments in cochlear implants, but the emphasis was on inequity: who is getting cochlear implants, who not — and that’s what I’ll write about.
Christine Dinh spoke first, and said that at the Miami center where she is a c.i. surgeon, measures of cochlear implant success were impressive. Over time, the average success in word recognition was 60 percent and in sentence recognition 100 percent. Diane Martinez, audiologist, suggested that this success rate might be the result of several factors: Spanish speakers do remarkably well with cochlear implants. She speculated that because Spanish is more multisyllabic and vowel-heavy compared to English, it might result in easier word recognition. Those who are bilingual score higher on word and sentence recognition tests in Spanish than they do in English. Nevertheless there is a low uptake of cochlear implants among Hispanics, who represent 70 percent of the population in Miami. Only 2.8 percent of those who are candidates have them.
Candace Hobson, of Emory, spoke about racial disparity in cochlear implantation. She said she had been at Emory for seven months before she encountered an African-American cochlear implant candidate. (The Atlanta metropolitan population is 33.6 percent African-American, according to the Metro Atlanta Chamber of Commerce.) One explanation is that many potential patients live in rural areas. Cochlear implantation requires a number of office visits for testing, surgery and post-op, programming and so on, and travel can be prohibitive. In addition, Medicaid regulations vary. Only 50 percent of state Medicaid programs cover cochlear implantation, which may affect minority participation. By contrast, Medicare covers implantation for all qualified patients.
Justin Golub talked about implantation in the elderly. Over 80 percent of those 80 and over need hearing aids and only 25 percent of those are treated. When it comes to cochlear implant success, age is not a factor. Among the elderly, which he defined as 75 and over for the purposes of the study, the risks from surgery are no different from those in younger groups when taking into account other health factors. The elderly do equally well in performance over time. The disparities in success result from the duration of deafness before implantation, daily usage of the implant, ant post-operative follow-up for mapping and adjustments. Interestingly, Golub said that one barrier is fear and lack of knowledge about cochlear implants in the medical community, who largely do not refer their older patients for cochlear implant evaluation.
This presentation be available on HLAA’s website as a captioned YouTube video.
Carrie Nieman, an otologist and public-health researcher at Johns Hopkins and a board member at HLAA, gave a workshop on hearing-care disparities and what we can do about them. Her suggestions included insuring that informed access about OTC devices is widely available. She also said that hearing professionals should encourage the use of inexpensive devices — like pocket talkers and “hearables” or “personal amplifiers” like the Sound World Solutions CS 50+ — for those who can’t afford hearing aids She said hearing health care itself should be broader and include community health workers partnering with hearing professionals, the training of peer educators, and other unconventional approaches to hearing car
There were too many excellent presentations to discuss them all, and I’ve focused on those whose subject was diversity. The final presentation of the convention, which will also be available on YouTube, was called “Diversity, Equity and Inclusion – The Conversation Has Started!” There’s too much to say about this one, so I’ll hold it for another post.
All in all, the workshops and presentations were invigorating and provocative, with lots of input from audience members.
The final offering on Saturday was a screening of the award-winning documentary “We Hear You — Now Hear Us,” produced by national board member Roxana Rotundo with board member Shari Eberts and New York City chapter members Toni Iacolucci and Holly Cohen. The 45 minute presentation was followed by a lively 45 minute discussion. As the program had promised, it mirrored the typical film-festival experience, complete with popcorn.
Next year’s convention will be in New Orleans. I’ll be there.
Although I took notes throughout the convention, I may be remembering specific facts somewhat inaccurately. I’ll correct as comments come in. In addition, if you were at Convention, please add your observations in the comments.
For more about living with hearing loss, read my books “Smart Hearing: Strategies, Skills and Resources for Living Better With Hearing Loss” and “Shouting Won’t Help: Why I and 50 Million Other Americans Can’t Hear You.” Both are available as ebook and paperback on Amazon.com.