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Updated: Aug 17, 2026
Robotic Cochlear Implantation for Direct Cochlear Access
Published on: June 16, 2022
Socioeconomic status and pediatric cochlear implant usage during COVID-19
Daniel R Awad1, Anthony J Tang1, Emily J Venskytis2
1University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Insights
Socioeconomic status impacted pediatric cochlear implant (CI) use during COVID-19. Children in higher SES areas maintained CI use better, while minority children and those older at implant faced greater reductions in CI usage.
Area of Science:
- Pediatric audiology
- Cochlear implantation
- Public health
Background:
- COVID-19 disrupted access to essential speech and hearing services for children.
- Understanding the impact of socioeconomic status (SES) on cochlear implant (CI) usage during the pandemic is crucial.
Purpose of the Study:
- To investigate the relationship between socioeconomic status and pediatric cochlear implant usage during the COVID-19 pandemic.
- To identify disparities in CI use based on SES and other demographic factors.
Main Methods:
- Retrospective review of pediatric patients (0-17 years) with CI visits between 2019-2022.
- Collected data on age, sex, race, insurance, and SES proxies (zip code).
- Compared hours of CI use in different listening environments across pre-COVID, COVID, and post-COVID periods.
Main Results:
- No significant difference in overall CI device use during COVID compared to pre-COVID.
- Children in areas with higher educational attainment showed smaller reductions in CI use and speech-in-noise listening during COVID.
- Minority race children and those older at implantation experienced greater reductions in CI use in the most recent period.
Conclusions:
- Socioeconomic factors influenced pediatric CI usage during the pandemic.
- Targeted interventions are needed to support CI use in at-risk populations during challenging times.
- Promoting rich listening environments at home is vital for equitable CI outcomes.
Objective:
COVID-19 (COVID) delayed access to speech and hearing services. The objective of this study was to identify interactions between socioeconomic status (SES) and cochlear implant (CI) usage during COVID.
Methods:
Consecutive pediatric patients (age 0-17) with CI and audiology visits between 2019 and 2022 at a tertiary care children's hospital were reviewed. Age, sex, race, insurance type, and proxy measures for SES using zip code were recorded. Hours spent with CI on and in different listening environments were compared between pre-COVID (1/1/2019-12/31/2019), COVID (4/1/2020-3/31/2021), and most recent (6/1/2021-5/31/2022) time periods.
Results:
Most patients were male (32/59, 54 % ears of 48 patients) and White, non-Hispanic (45/59, 76 %). Median age at implant was 2.0 years (range:0.6-12.2). There were no significant differences in hours spent with CI on during COVID compared with pre-COVID. However, children spent more time listening to louder noises (70-79 dB and ≥80 dB) recently compared with during COVID (p = 0.01 and 0.006, respectively). During COVID, children living in areas with greater educational attainment showed smaller reductions in total hours with CI on (β = 0.1, p = 0.02) and hours listening to speech in noise (β = 0.03, p = 0.005) compared with pre-COVID. In the most recent time period, children of minority race (β = -3.94 p = 0.008) and those who were older at implant (β = -0.630, p = 0.02) were more likely to experience reductions in total hours with CI on compared with during COVID.
Conclusion:
Interventions which mitigate barriers of implant use and promote rich listening home-environments for at risk populations should be implemented during challenging future social and environmental conditions.
