Social Determinants of Health and Adult Cochlear Implantation: A Scoping Review

Cochlear implants (CIs) are a cornerstone of hearing rehabilitation for individuals with severe-to-profound hearing loss, yet they remain underutilized among eligible adults. Social determinants of health (SDOH) describe the nonmedical factors shaping health outcomes, including the conditions in which individuals live, work, and age, as well as broader influences like social norms and economic policies. These factors likely contribute to the disparity in CI utilization. This scoping review aims to identify articles addressing SDOH data and highlight gaps that may explain the underuse of CI in eligible adults.

Academic journals, published articles, surveys, and observational research.

To create the systematic search, a health sciences librarian collaborated with the research team to develop a relevant keyword list. An initial PubMed search was created using the keyword list and input from the researchers. In addition to input on keywords, the research team provided nine sentinel articles to test the searches against. All searches were reported by adhering to the PRISMA searching extension.

Following an initial search in 2022 and an update in 2025, 29,654 articles remained eligible for the title and abstract screening. Ultimately, a total of 67 articles were eligible for inclusion. Articles were categorized by SDOH domain.

While literature on the topic has expanded over time, a more comprehensive understanding of SDOH as related to CI candidates and recipients may improve access to this technology for all who could benefit.

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