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New Study Examines Inequality in Treatment for Hearing Loss

New Study Examines Inequality in Treatment for Hearing Loss

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Hearing loss seems like one of the great equalizers of old age, striking people of all kinds as their ears gradually lose the ability to pick out sounds or hear certain pitches.

But a new national study reveals major gaps in whether Americans over age 55 get help for their hearing loss—gaps that vary greatly by age, race, education, and income, according to an article published on the Michigan Medicine website.

In all, just over a third of older adults who say they have hearing loss are using a hearing aid to correct it, the study finds. But those who are non-Hispanic white, college educated, or have incomes in the top 25% were about twice as likely as those of other races, education levels, or income ranges to have a hearing aid.

The cost of hearing aids is most to blame, say the researchers from the University of Michigan who published the study in The Gerontologist. They presented it this week at the annual research meeting of the AcademyHealth professional society for health care researchers.

Hearing aids can cost thousands of dollars out of a patient’s pocket because most health insurance programs, including Medicare, don’t cover them.

In fact, the study finds that the only factor that leveled the playing field for hearing aid use was having insurance through the Department of Veterans Affairs, which covers hearing aids in many cases. Hearing-impaired veterans ages 55 to 64 were more than twice as likely as their nonveteran peers to use a hearing aid, even after the researchers corrected for other differences. The gap between veterans and nonveterans was also significant for those over 65.

But the detailed interviews conducted for the study also show that personal concerns about hearing aid use, and lack of engagement with health providers, play a role.

“Hearing aids are not easy for many to obtain due to their costs,” says Michael McKee, MD, MPH, the U-M family medicine physician and assistant professor who led the analysis.

Michael McKee, MD, MPH

Michael McKee, MD, MPH

“However, there are a number of additional issues that place at-risk groups at an even larger disadvantage to achieving good hearing health. Many of these issues are beyond the financial aspects, including racial/ethnicity and sociocultural elements, for instance stigma and vanity.”

National survey and local interviews

McKee, who uses a cochlear implant to overcome his own hearing loss, worked on the study with Helen Levy, PhD, a health economist and professor at the U-M Institute for Social Research, and other colleagues. The authors are members of the U-M Institute for Healthcare Policy and Innovation.

They used survey data from the nationally representative Health and Retirement Study, which is based on interviews conducted by the Institute for Social Research with funding from the National Institutes of Health.

The analysis included data from more than 35,500 people nationwide over age 55 who said they had hearing loss. In addition, McKee and colleagues conducted in-depth interviews with 21 other older adults with hearing loss in the communities surrounding the university.

The authors conclude that the Centers for Medicare & Medicaid Servicesshould consider covering hearing aids for Medicare participants and those in Medicaid plans for lower-income adults of any age. Some state Medicaid plans do cover hearing aids, but it is not required.

“Many people may not realize that Medicare does not cover hearing aids,” says Levy. “But it doesn’t, so cost can be a significant obstacle preventing older adults with hearing loss from getting the help that they need.”

More findings from the study:

  • The percentage of older adults with hearing loss who used a hearing aid rose with age, from about 15% of those in their late 50’s to more than 57% of those in their late 80s.
  • Forty percent of non-Hispanic white adults with hearing loss used a hearing aid, compared with 18.4% of non-Hispanic black and 21.1% of Hispanic adults with hearing loss.
  • Nearly 46% of hearing-impaired older adults who had gone to college reported that they used a hearing aid, compared with just under 29% of those who hadn’t graduated from high school.
  • Nearly half of those with incomes in the top 25% wore a hearing aid, compared with about one-quarter of those in the bottom 25%.
  • There were no significant differences in hearing aid use based on the size of the community where the person lived, nor their level of health literacy as measured on a standard test.
  • Interviews showed that cost, lack of insurance coverage (or knowledge about insurance coverage), vanity, and stigma were common reasons for not using hearing aids. Participants also cited a lack of attention to hearing loss by their primary care provider and worries about finding an audiologist they could trust.
  • Many interview participants who used a hearing aid mentioned efforts that hearing-related professionals made to connect them to discounts and insurance programs.

More about hearing loss

Estimates of hearing loss incidence place it at 29% of people in their 50s, 45% of those in their 60s, 68% of those in their 70s, and 89% of those in their 80s.

Previous studies have shown that untreated hearing loss reduces older adults’ ability to carry out everyday tasks, reduces their quality of life, and is linked to social isolation, lower income, reduced cognitive function, and poorer physical and psychological health.

A recent study led by McKee’s colleague Elham Mahmoudi, PhD, found that having a hearing aid was associated with a lower chance of being hospitalized or visiting an emergency room in the past year. That study focused on people over 65 who had severe hearing loss, and it used data from a federal database.

McKee leads the Health Info Lab, which is researching health information use and literacy among deaf and hard-of-hearing individuals.

This article is copyrighted by the University of Michigan and used with permission.

Original Paper: McKee MM, Choi H, Wilson S, DeJonckheere MJ, Zazove P, Levy H. Determinants of hearing aid use among older Americans with hearing loss. The Gerontologist. 2018. Available at: https://academic.oup.com/gerontologist/advance-article-abstract/doi/10.1093/geront/gny051/5000029?redirectedFrom=fulltext

Source: Michigan Medicine/University of Michigan, The Gerontologist

Image: University of Michigan

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City, University of London to Pilot Language and Reading Intervention for Children

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Researchers from City, University of London have been awarded £97k ($USD approximately $136,479) from the Nuffield Foundation to pilot a language and reading intervention with 120 children in their first year of formal education, the school announced on its website.

Involving Dr Ros Herman, Professor Penny Roy, and Dr Fiona Kyle from the School of Health Science’s Division of Language and Communication Science, in collaboration with Professor Charles Hulme from Oxford University, the study—which is reportedly the first reading intervention study to include both deaf and hearing children—will trial the new intervention in primary schools for a year and compare outcomes with other schools that offer the standard literacy teaching.

The research team have shown in previous research that many severely and profoundly deaf children have significant reading delays, yet are typically excluded from reading intervention research.

In this new study, teachers will be trained to deliver the intervention program, comprising systematic phonics teaching alongside a structured vocabulary program, during the school literacy hour. The study will investigate whether all children, or only specific groups of children, benefit from the integrated program and whether a full-scale evaluation is merited.

Dr Herman said, “Our previous research has revealed the scale of reading difficulties among deaf children. Our findings suggest that deaf children will benefit from specialist literacy interventions such as those currently offered to hearing children with dyslexia. In addition, deaf children and many hearing children require ongoing support to develop the language skills that underlie literacy.

“As a result we hope our new study, which will pilot a combined language and reading intervention, will address these issues so that teachers can provide the vital support needed to prevent both hearing and deaf children from unnecessarily falling behind their peers.”

Source: City, University of London

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GN Store Nord Develops Device to Protect Soldiers’ Hearing

GN Store Nord Develops Device to Protect Soldiers’ Hearing

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GN Store Nord has announced a “first of its kind, fully fledged hearing protection solution, enabling defense and security forces to hear more, do more, and be more.” With this advanced tactical hearing-protection solution, GN reports that it is leveraging unique leading competencies within intelligent audio solutions in both hearing aids and headsets to create an unparalleled noise management solution. The product will be manufactured at its Bloomington, Minn, facility where ReSound is also located.

The global market for military communication systems is estimated to be about $630 million, and features competitors such as Peltor (3M), INVISIO, Silynx, Racal Acoustics, and MSA Sordin, according to long-time hearing industry analyst Niels Granholm-Leth of Carnegie Investment Bank in Copenhagen.  GN has embarked on several projects in its GN Stratcom organization, which is currently part of GN Hearing, although the company could eventually establish it as a stand-alone division alongside its Hearing (ReSound, Beltone, and Interton) and Headset divisions (Jabra).

The new patented hearing protection solution is designed specifically for defense and security forces. GN says the solution offers the user a communication headset which is designed to be comfortable, highly durable, and protects the user against high volume noise. At the same time, by leveraging GN’s expertise within situational awareness, the solution allows its user to clearly identify important sound in 360°.

Anders Hedegaard

Anders Hedegaard

“The GN Group encompasses consumer, professional, and medical grade hearing technology under the same roof,” says CEO of GN Hearing, Anders Hedegaard. “This unique platform makes it possible to expand GN’s business into adjacent opportunities within the sound space. With our user-centric approach we aim to be the leader in intelligent audio solutions to transform lives through the power of sound.”

GN will be starting to build a small, swift group related to this new business opportunity. This year, GN will participate in military tenders in the United States and with other NATO-countries. The new product line will, under the name GN FalCom, include:

  • Comfort. Designed for optimal physical comfort allowing for multiple hours of use in extreme combat situations;
  • Clarity. Enables users to localize sounds all around them without the need to remove the earpiece. To maintain high quality communications at all times, GN FalCom will integrate seamlessly with military radio technology, and
  • Protection. Allows users to stay connected while benefitting from noise protection. For example, users will experience the highest level of safety without blocking out wanted sounds.

The  hearing protection solution builds on GN’s expertise in sound processing from both GN Hearing and GN Audio—and across R&D teams in the United States and Denmark. It is a successful result of corporate level investments made through GN’s Strategy Committee guided initiatives to explore opportunities outside of, but related to, GN’s existing business areas. According to the company, the hearing protection solution will be manufactured at GN’s existing production facilities in Bloomington, Minn, and will not impact GN’s financial guidance for 2018.