Groundbreaking Report Could Accelerate Changes in Hearing Loss Care
Hearing loss is more than an inconvenient fact of life among aging adults. It is a national health problem that affects 30 million people in the United States, according to a recent report published by The National Academies of Sciences, Engineering, and Medicine.
Between 67 and 86 percent of people who need hearing aids or assistive devices don’t have them, don’t use them, or don’t even have access to hearing health care. The problem will get worse as the population of older adults increases.
“Many people look at hearing loss as something that happens when you get older, not something that the public needs to be concerned about,” says Duke’s Dan Blazer, MD, PhD, who chaired the National Academies’ 17-member Committee on Accessible and Affordable Hearing Health Care for Adults.
“We used to think beginning to lose your memory was part of normal aging,” Dr. Blazer continues. “Now we know it could be an early stage of Alzheimer’s disease—and that knowledge has completely changed our thinking about the way it [memory loss] is treated. We are in the same place now with hearing loss as we were 40 years ago with memory loss.”
Hearing Loss Checklist
You may have hearing loss if you ….
- frequently ask people to repeat themselves.
- have trouble keeping up with the conversation in a group.
- complain about other people mumbling or not speaking clearly.
- have difficulty understanding children or women with high voices.
- find it harder to understand people when not face-to-face with them.
- have to concentrate harder when talking on a cell phone.
- avoid going out with friends or attending family gatherings.
- take medications potentially harmful to hearing.
Multiple Effects. The committee found that the hearing loss problem is evident at many levels.
A growing body of evidence shows that hearing loss is associated with additional health conditions, including heart disease, loss of memory, and social isolation. People with hearing loss are less likely to interact with others. Their world gets smaller because they don’t participate in as many normal activities of living. These hearing loss-related problems are further evidence that the condition does not exist in a vacuum.
Hearing-related services are often overlooked. Assessment of a person’s condition, diagnosis of possible underlying medical causes, and precise evaluation of a person’s hearing loss are vital but expensive, and difficult to access. In many cases, hearing health care does not reach underserved people who need it.
Expensive. Hearing aids cost, on average, $4,700. To complicate matters, Medicare does not cover the cost of hearing aids.
“Most people don’t realize that hearing aid costs are bundled,” says Dr. Blazer. “We don’t just pay for the hearing aids, but also for the services associated with the devices. The committee recommends that pricing and services be made more transparent to the consumer.”
Outdated. Regulations regarding hearing aids are old, outdated, and hard to change. For example, the Food & Drug Administration (FDA) requires a person to see a health care professional before getting hearing aids, but they can avoid that hurdle by signing a waiver. In fact, most people go straight to a hearing aid vendor, not a hearing health professional.
Alternatives. “Hearing loss does not necessarily mean that a person needs a hearing aid,” says Dr. Blazer. “There is a role for audiologists in teaching people with hearing loss how to deal with the problem. as well as those affected by others’ loss of hearing.” (See “Strategies to Improve Person-to-Person Communication.”)
Less expensive listening assistive devices—not hearing aids, per se—might help those with mild or moderate hearing loss. The cost can be as low as $100.
Recommendations. Hearing loss care can be addressed by regulatory agencies, medical professionals, and people who have hearing loss. The committee made 12 recommendations. The following are some examples:
- Improve awareness of hearing health care as a public health issue.
- Remove the FDA’s regulation for medical evaluation before getting hearing aids.
- Include hearing health in wellness and medical visits.
- Give consumers more control and transparency regarding their hearing health care.
- Make access to underserved populations more available and affordable.
- Create a new FDA device category for over-the-counter hearing devices.
- Improve the compatibility of hearing technologies with other communications devices.
- Make hearing aids and other hearing devices more affordable.
What Now? Now that the National Academies’ report has gotten national attention, what happens next?
“What the committee really wants is for hearing health care ‘stakeholders’ (individuals, industries, professionals, non-profit organizations, government agencies, medical and scientific communities) to push this issue forward and make changes,” says Dr. Blazer. “The timeline could be long for some, but others (like awareness, pricing, and transparency) could happen quickly.”
The take-home message, says Dr. Blazer, is to:
1) understand that hearing loss is a health problem, not just something that “happens,”
2) do something about it, and
3) understand that addressing the problem is not just the responsibility of individuals, but of society as a whole.
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