Spatial and temporal associations between physical establishment density and hearing difficulty across US counties

Area of Science:

• Environmental health
• Public health
• Urban planning

Background:

• Hearing loss affects over 15% of US adults, posing a significant public health challenge.
• Previous research focused on physiological and socioeconomic factors, neglecting environmental influences.
• The built environment's role in hearing health disparities requires further investigation.

Purpose of the Study:

• To examine spatial and temporal links between physical establishment density and hearing difficulty rates in US counties.
• To identify specific types of establishments associated with increased hearing difficulty.
• To understand how infrastructure and urban characteristics modify the relationship between built environment and hearing health.

Main Methods:

• Bivariate correlation analysis to assess initial associations.
• Regression analyses controlling for sociodemographic factors and road density.
• Temporal clustering analysis to identify trends from 2012-2021.
• Identification and analysis of 'hearing-health-risky' physical establishments.

Main Results:

• Initially, higher physical establishment density correlated with lower hearing difficulty rates.
• After controlling for covariates, physical establishment density showed a positive association with hearing difficulty.
• Road density significantly influenced this relationship, indicating infrastructure's role.
• Hearing-health-risky establishments demonstrated a stronger positive association with hearing difficulty.
• Increasing hearing difficulty trends were linked to higher physical establishment density in temporal analysis.

Conclusions:

• While dense built environments currently show lower aggregate hearing difficulty, they may harbor growing long-term risks.
• Urbanized settings require targeted noise management and planning to mitigate hearing health threats.
• Findings inform public health policies and urban planning for better hearing health outcomes.