Related Experiment Video
Updated: Jun 10, 2025
Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Inclusive Soundscapes: How Race, Socioeconomic Status and Maternal Age Influence the Pediatric Cochlear Implant
Sofia Torres-Small1, Christina N Ward2,3, Sarah L Thurmond4
1University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA.
Insights
Social vulnerability and race impact pediatric cochlear implant (CI) access and usage. Addressing disparities in diagnosis, CI use, and follow-up is crucial for equitable care.
Area of Science:
- Pediatric Otolaryngology
- Health Disparities Research
- Audiology
Background:
- Access to pediatric cochlear implants (CI) is vital for hearing rehabilitation.
- Factors like race, social vulnerability, and maternal age may influence CI outcomes.
- Understanding these disparities is key to improving equitable access.
Purpose of the Study:
- To evaluate the impact of race, social vulnerability, and maternal age on pediatric CI access and usage.
- To identify potential barriers to timely diagnosis and consistent CI use.
- To inform strategies for reducing healthcare disparities in pediatric hearing loss.
Main Methods:
- Retrospective cohort study of 302 pediatric CI recipients (2000-2022).
- Analysis of race, maternal age, and social vulnerability index (SVI) data.
- Assessment of age at diagnosis, CI implantation, device usage, and follow-up rates.
Main Results:
- Race and SVI were significantly associated (P < .001).
- Higher SVI correlated with delayed hearing loss diagnosis and CI implantation (P < .05).
- Increased SVI linked to reduced daily CI usage and higher likelihood of lost follow-up (P < .05).
Conclusions:
- Significant disparities exist in pediatric CI care influenced by race and social vulnerability.
- Timely diagnosis, consistent CI use, and follow-up are critical areas for intervention.
- Developing targeted strategies is essential to overcome barriers and promote equitable access to CI technology.
Objective:
This study aimed to assess how race, social vulnerability, and maternal age influence pediatric cochlear implant access and usage.
Study Design:
Retrospective cohort.
Setting:
Tertiary Pediatric University Hospital.
Methods:
This study included individuals aged 0 to 18 who received a cochlear implant at our center between the years 2000 and 2022. Social vulnerability data from 2020 was obtained from the Centers for Disease Control and Prevention.
Results:
Of the 302 patients included in our study, 43% were black and 50% were white. Patients from the highest to lowest social vulnerability quintiles comprised 31%, 25%, 18%, 10%, and 14% of our sample, respectively. Race was associated with social vulnerability index (SVI) (P < .001), with a mean score of 0.70 (±0.26) and 0.49 (±0.27) for black and white patients, respectively. Later age at hearing loss (HL) diagnosis and cochlear implantation (CI) were associated with more and most vulnerable SVI (P < .05). Delayed diagnosis was also associated with black and other racial groups (P = .041), and adolescent maternal age (P = .03). Greater SVI was associated with less daily cochlear implant usage (P = .004). The most vulnerable patients were more likely to be lost to follow-up (P = .03) despite no difference based on maternal age (P = .59) and insurance status (P = .47).
Conclusion:
This study underscores the significance of mitigating disparities in timely diagnosis of HL, consistent CI usage, and appropriate follow-up care. This is a first step toward the formulation of novel strategies aimed at overcoming barriers and developing appropriate intervention programs.
