Disparities in Hearing Aid Use Among Those With Hearing Loss in Rural and Urban Settings

Area of Science:

• Audiology and Public Health
• Health Services Research
• Socioeconomic Determinants of Health

Background:

• Hearing loss affects a significant portion of the population, with access to audiological services potentially varying by geographic location.
• Hearing aid adoption is crucial for managing hearing loss but may be influenced by socioeconomic and environmental factors.
• Understanding disparities in hearing aid use is essential for developing equitable healthcare strategies.

Purpose of the Study:

• To examine potential disparities in hearing aid utilization between individuals residing in urban versus rural settings.
• To investigate the influence of income level on hearing aid use in both urban and rural populations.
• To identify specific demographic groups that may benefit from targeted hearing health interventions.

Main Methods:

• Utilized pooled cross-sectional data from the 2017-2018 Medicare Current Beneficiary Survey (MCBS).
• Included 8107 participants reporting hearing loss and complete covariate data.
• Employed multivariate logistic regression to analyze the impact of residence (urban/rural) and income relative to Federal Poverty Level (FPL) on hearing aid use.

Main Results:

• No statistically significant difference in hearing aid use was observed between urban and rural participants when residence was considered alone.
• High-income rural residents showed the highest odds of hearing aid use (OR: 1.99) compared to low/middle-income rural residents.
• High-income urban residents (OR: 1.57) and low/middle-income urban residents (OR: 1.31) also had increased odds compared to the rural low/middle-income group.

Conclusions:

• Interactions between metropolitan status and income significantly influence hearing aid use, particularly in rural areas.
• Findings suggest that hearing loss interventions could be more effectively targeted towards rural, low-income populations.
• Policy development should consider the nuanced relationship between geography, income, and access to hearing healthcare.