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Rurality and determinants of hearing healthcare in adult hearing aid recipients
Author(s) -
Chan Stephen,
Hixon Brian,
Adkins Margaret,
Shinn Jennifer B.,
Bush Matthew L.
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26490
Subject(s) - hearing loss , rurality , medicine , audiology , hearing aid , rural area , medicaid , socioeconomic status , referral , demographics , rehabilitation , demography , health care , population , family medicine , physical therapy , environmental health , pathology , sociology , economics , economic growth
Objective The objective of this study was to compare the timing of hearing aid (HA) acquisition between adults in rural and urban communities. We hypothesized that time of acquisition of HA after onset of hearing loss is greater in rural adults compared with urban adults. Secondary objectives included assessment of socioeconomic/educational status and impact of hearing loss and hearing rehabilitation of urban and rural HA recipients. Study Design Cross‐sectional questionnaire survey. Methods We assessed demographics, timing of HA fitting from onset of hearing loss, and impact of hearing impairment in 336 adult HA recipients (273 urban, 63 rural) from a tertiary referral center. Amplification benefit was assessed using the International Outcome Inventory for Hearing Aids (IOI). Results The time to HA acquisition was greater for rural participants compared to urban participants (19.1 vs. 25.7 years, P = 0.024) for those with untreated hearing loss for at least 8 years. Age at hearing loss onset was correlated with time to HA acquisition ( P = −0.54, P < 0.001). Rural HA participants experienced longer commutes to hearing specialists (68 vs. 32 minutes, P < 0.001), were less likely to achieve a degree beyond high school ( P < 0.001), and were more likely to possess Medicaid coverage ( P = 0.012) compared to urban participants. Hearing impairment caused job performance difficulty in 60% of all participants. Conclusion Rural adults are at risk for delayed HA acquisition, which may be related to distance to hearing specialists. Further research is indicated to investigate barriers to care and expand access for vulnerable populations. Level of Evidence 4. Laryngoscope , 127:2362–2367, 2017