Hearing the Classes: A Study of Cochlear Implantation and Socioeconomic Status

Katherine Koniares

doi:10.6017/eurj.v6i2.9035

Abstract

Profound hearing loss affects thousands of people in the United States and the United Kingdom, with a higher incidence among people of low socioeconomic status. A cochlear implant is a surgically implanted device that has been demonstrated to improve communication and quality of life among profoundly hearing-impaired individuals. This review postulates that the rate of cochlear implantation among eligible candidates can be used to assess quality of healthcare, with a view toward examining disparities in healthcare services both in American free-market system and in the British National Health Service. A systematic literature search was performed for pertinent articles investigating socioeconomic status and cochlear implantation. Data from twenty-two sources were analyzed, and it was shown that-despite differences in the healthcare systems of the United States and England-similar trends are apparent in the two countries with regard to a lower rate of pediatric cochlear implantation surgery in children with profound hearing loss as familial socioeconomic status decreases.

Highlights

Several studies have explored the relationship between payment methods used to cover the costs o f a Cochlear implantation (CI) i n the United States and UnitedKingdom, and reimbursement rates for hospitals
Despite differences i n the healthcare systems i n the United States and the UnitedKingdom, there is strong evidence supporting the presence o f SES disparities w i t h regard to cochlear implantation i n both countries
This may be because families withahigher SES are m o r e concerned withhealthand are less discouraged by personal expenses, s u c h as timeand travel, incurred for utilizing healthcare facilities

Summary

Introduction

Hearing loss is one of the most prevalent health conditions i n the United States and England, w i t h moderate to prof oundbilateralhearing loss diagnosed i n 2-3 infants per 1,000 births i n the United States and 1 per 1,000 births i n England. Fifty to ninety percent more children are diagnosed w i t h hearing impairment by 9 years o f age. Child renfromlowerincome families are twice as likely to be deaf when compared to children from higher income families.3Degrees o f hearing loss are measured i n decibels, and are defined as moderately severe (66-74 d B ) , severe (75-90 dB), or profound (>90 dB), according to the 4-frequency (500, 1000, 2000, and 4 0 0 0 Hz) pure-tone average (PTA). Cochlear implantation (CI) is an option for individuals w i t h severe to profound hearing loss, who receive minimal benefit from hearing aids. A CI is an electronic device surgically embedded i n the inner ear, used to stimu late the auditory nerve i n response to sound and generate the outcome o f hearing. Unlike hearing aids, a CI requires surgery and necessitates considerable costs throughout the patient's lifetime. PCIs differ from their adult equivalents because children depend on CIs to learn spoken language skills a n d require costly a n d extensive habilitation. Hearing loss is one of the most prevalent health conditions i n the United States and England, w i t h moderate to prof oundbilateralhearing loss diagnosed i n 2-3 infants per 1,000 births i n the United States and 1 per 1,000 births i n England.. Fifty to ninety percent more children are diagnosed w i t h hearing impairment by 9 years o f age.. Degrees o f hearing loss are measured i n decibels, and are defined as moderately severe (66-74 d B ) , severe (75-90 dB), or profound (>90 dB), according to the 4-frequency (500, 1000, 2000, and 4 0 0 0 Hz) pure-tone average (PTA).. A CI requires surgery and necessitates considerable costs throughout the patient's lifetime.. PCIs differ from their adult equivalents because children depend on CIs to learn spoken language skills a n d require costly a n d extensive habilitation. A successful CI may lead to improved academic achievement, superior employment opportunities, a n d decreased dependence o n social services as a n adult.

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Discussion

Conclusion