Abstract
Hearing loss is associated with cognitive decline and impairment in daily living activities. Access to hearing health care has broad implications for healthy aging of the U.S. population. This qualitative study investigated factors related to the socio-ecological domains of hearing health in a U.S.–Mexico border community experiencing disparities in access to care. A multidisciplinary research team partnered with community health workers (CHWs) from a Federally Qualified Health Center (FQHC) in designing the study. CHWs conducted interviews with people with hearing loss (n = 20) and focus groups with their family/friends (n = 27) and with members of the community-at-large (n = 47). The research team conducted interviews with FQHC providers and staff (n = 12). Individuals experienced depression, sadness, and social isolation, as well as frustration and even anger regarding communication. Family members experienced negative impacts of deteriorating communication, but expressed few coping strategies. There was general agreement across data sources that hearing loss was not routinely addressed within primary care and assistive hearing technology was generally unaffordable. Community members described stigma related to hearing loss and a need for greater access to hearing health care and broader community education. Findings confirm the causal sequence of hearing impairment on quality of life aggravated by socioeconomic conditions and lack of access to hearing health care. Hearing loss requires a comprehensive and innovative public health response across the socio-ecological framework that includes both individual communication intervention and greater access to hearing health resources. CHWs can be effective in tailoring intervention strategies to community characteristics.
Highlights
Across the world people are living longer, increasingly challenging countries to address the cumulative and chronic disabilities that accompany old age [1]
The impact of hearing loss on quality of life is well documented [6], but more recent studies have demonstrated an association between hearing loss and accelerated cognitive decline [7] and even dementia [8]
We present the results of a qualitative study of hearing loss in Nogales, Arizona that draws from a diversity of perspectives to explore the multiple influences on hearing health and access to hearing health care
Summary
On a global level, hearing loss is the most prevalent disabling condition; lack of trained hearing health professionals and limited access to assistive technology restricts access to hearing health-care services [2]. Age-related hearing loss is associated with impairment in daily physical activities [4] and increased risk of falls, possibly related to the negative impact of hearing impairment on balance or awareness of surrounding environments [5]. The impact of hearing loss on quality of life is well documented [6], but more recent studies have demonstrated an association between hearing loss and accelerated cognitive decline [7] and even dementia [8]. With the expanding need for hearing health care being met only marginally for those who can afford assistive hearing technology, a comprehensive public response is long overdue [10]
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