Rurality Effect on Michigan Newborn Hearing Screening

Area of Science:

• Public Health
• Audiology
• Rural Health Disparities

Background:

• Newborn hearing screening (NBHS) is crucial for early detection of hearing loss.
• Understanding factors influencing screening outcomes is essential for improving access and effectiveness.
• Rurality may present unique challenges to healthcare access and adherence.

Purpose of the Study:

• To evaluate the impact of rurality on newborn hearing screen outcomes in Michigan.
• To compare hearing screen outcomes based on U.S. Department of Agriculture Rural-Urban Continuum Codes (RUCC).

Main Methods:

• Analysis of the Michigan Department of Health and Human Services (MDHHS) Newborn Hearing Screening database (2015-2020).
• Categorization of patients into rurality levels (RUCC codes 1-9) based on zip code population.
• Comparison of outcomes including screening refusal, failed screens, and follow-up testing across different rurality levels.

Main Results:

• A total of 34,928 patients were initially identified.
• Patients in more rural areas (higher RUCC) were significantly more likely to refuse screening (mean RUCC 4.2) compared to those with failed initial screens (mean RUCC 2.1).
• Equipment failure was also more common in more rural areas (mean RUCC 2.8) compared to completed screenings.

Conclusions:

• Increased rurality is associated with higher rates of newborn hearing screen refusal and equipment failure.
• No significant difference in rurality was observed between patients who had follow-up testing after a failed screen and those who did not.
• Targeted interventions may be needed to address rural disparities in newborn hearing screening.