Factors Associated With Frequency and Hours of Daily Hearing Aid Use in the United States

To identify factors associated with the frequency and hours of daily hearing aid (HA) use in the United States.

Adults with hearing loss participating in the National Health and Nutrition Examination Survey (NHANES; 2011-2020) were analyzed (n = 1523). Multivariable regression was used to identify factors associated with frequency and hours of daily HA use.

In this nationally representative cohort of U.S. adults, factors associated with higher odds of HA use among younger participants (age 20-69) included having military (OR 6.33, 95% CI: 1.19-33.72) and government (OR 16.0, 95% CI 2.16-118.65) insurance. Among younger participants who have worn HAs before, higher odds of wearing HAs frequently included having private (OR 9.62, 95% CI: 1.12-82.57), Medicare (OR 5.49, 95% CI: 1.17-25.67), and state-sponsored insurance (OR 15.62, 95% CI: 1.35-180.93). For older participants (age ≥ 70), being Hispanic (OR 0.40, 95% CI 0.18-0.88, ref = White) and having an income-poverty ratio (IPR) < 1.3 (OR 0.27; 95% CI: 0.11-0.68, ref = 4+) were associated with lower odds of HA use. Being Hispanic (OR 0.07; 95% CI 0.02-0.20, ref = White) or Black (OR 0.20, 95% CI: 0.10-0.38, ref = White) and having government insurance (OR 0.16, 95% CI: 0.08-0.33) were associated with fewer hours of daily HA use.

Insurance type was associated with HA use in younger participants due to variable HA coverage benefits. In older participants who are homogenously covered by Medicare, associations of low income and government insurance with HA use may reflect socioeconomic and benefit-related barriers. Reasons for HA use disparities for Hispanic Americans likely extend beyond insurance and socioeconomic factors which some suggest these as the most significant explanations for disparity.

3.