Abstract
Objective.To examine whether socioeconomic position (SEP) is associated with progression in the health-seeking process for hearing loss.Method.Logistic regression of data from a cross-sectional survey representative of noninstitutionalized, 50 years and older population of England (ELSA wave 2, 2004). Using self-reported hearing difficulty as starting point, we examined the association between SEP and health-seeking behaviors in 6 stages leading to hearing aid acquisition and use.Results.Higher SEP was associated with lower odds of self-reported hearing difficulty, adjusted odds ratio [OR] = 0.87 (95% confidence interval [CI] 0.83–0.91, p < .001). There was marginal negative association between higher SEP and receiving hearing aid recommendation (adjusted OR = 0.88, 95% CI 0.78–0.99, p = .05). SEP was not associated with any other stage of health-seeking behavior.Discussion.Among the noninstitutionalized older population of England, SEP-related inequalities exist in the prevalence of self-reported hearing loss. However, SEP is not strongly associated with progression in the remaining stages of health-seeking process during and after an individual’s contact with the health system.
Highlights
Among the older population in England, nearly half of self-perceived hearing difficulty is unreported to health professionals, and remains untreated
SEP was strongly associated with odds of self-reported hearing difficulty
In regard to the objective of this study, we found that individuals of different SEP scores appeared to receive equitable levels of care upon approaching a health care professional with self-perceived hearing loss, and no SEP gradient was identified in ownership and utilization of hearing aids
Summary
The Sample This study used data from the second wave of the ELSA due to availability of self-reported information on the existence of hearing difficulty and consecutive multiple stages of health-seeking behavior. The ELSA cohort originated from the Heath Survey for England (HSE or ELSA Wave 0), which provided enrollment of more than 12,000 core members and baseline data about them between years 1998 and 2001 (Cheshire, Cox, Lessof, & Taylor, 2006; Taylor, Conway, Calderwood, & Lessof, 2002). Sample weights provided with the data set were used to adjust for nonresponse between HSE and ELSA Wave 1 and between ELSA wave 1 and 2 (82% of Wave 1 core members participated in Wave 2) in order to retain the representativeness of the sample
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