Hearing Aids: Who’s Using Them?

Multiple studies have shown that hearing loss has a variety of negative effects. Hearing impairment contributes to a range of social and functional limitations, and has been negatively associated with cognitive, communicative, and emotional outcomes. However, it is estimated that only one quarter of Americans with a hearing impairment use hearing aids. Despite concern over the prevalence of untreated hearing loss, past research on hearing aid use has not included population-based or prospective methods. These methods are needed for better estimates of the rate of hearing aid use, and to learn why most individuals do not pursue treatment for hearing loss.

A recent article in the American Journal of Public Health presents a primary study of hearing aid acquisition. The study involved participants of the longitudinal, population-based Beaver Dam Eye Study in Beaver Dam, Wisconsin. All residents of the township between the ages of 43 and 84 were offered hearing exams at three different, five-year intervals, and over the course of 10 years. Participants in the most recent study were those residents who were assessed with hearing loss at either of the first two intervals. The researchers recorded whether or not participants had used a hearing aid at or before any of these time points. Thus, the researchers were able to identify individuals who had a pre-existing or recent hearing loss, and whether or not they acquired a hearing aid at any point during this period.

In addition to the hearing exam, researchers collected demographic data and administered a cognitive status test as well as a questionnaire on the emotional and situational effects of a hearing problem. The participants also reported their own self-perceived hearing quality, whether they felt they had hearing loss, and whether friends or family members believed he/she had hearing loss. The researchers also asked individuals who did not acquire a hearing aid their reasons for doing so and used this data to identify which factors predicted hearing aid use among this particular population.

Only 14.3 percent of individuals assessed with a hearing loss acquired a hearing aid within five years, while 35.7 percent did so within 10 years. Being a college graduate increased the likelihood of acquiring a hearing aid, which the authors point out might relate to education’s high correlation with income, which was not analyzed in the study. Self-perception of hearing loss was the strongest predictor of hearing aid acquisition. Interestingly, previous research suggests that individuals concerned about the cost or stigma of having a hearing aid are less likely to self-identify a hearing impairment. Other than self-perception, concerns about the cost and inconvenience of a hearing aid, and knowing others who have had a poor experience with a hearing aid were commonly reported reasons for not acquiring one. This research suggests that the widespread acceptance of technology to assist hearing loss remains a significant challenge.


Fischer, M.E., Cruickshanks, K.J, Wiley, T.L., Klein, B.E., Klein, R., and Tweed, T.S., (2011). “Determinants of Hearing Aid Acquisition in Older Adults.” American Journal of Public Health, 101(8).


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