New research demonstrated substantial differences in hearing loss prevalence and associated risk factors across sex and race groups, with potential implications for tailored hearing loss prevention strategies.
Key Findings
In a community-based cohort study of 1,787 adults (mean age = 61.3 years), investigators found an overall hearing loss prevalence of 46.2%, with marked differences between demographic groups. White male individuals showed the highest prevalence (60.7%), followed by White female individuals (42.1%), Black male individuals (33.6%), and Black female individuals (29.2%).
"Understanding sex and race differences in the prevalence of hearing loss and associated factors is important for health care planning and for the development and implementation of tailored public health interventions to prevent or manage hearing loss as the population ages," wrote lead study author Lauren K. Dillard, PhD, AuD, of the Medical University of South Carolina, and her colleagues.
Methodology
The ongoing Medical University of South Carolina Longitudinal Cohort Study of Age-Related Hearing Loss, launched in 1988, provided the data for this analysis. Hearing loss was defined as a worse-ear pure-tone average of thresholds at frequencies 0.5, 1.0, 2.0, and 4.0 kHz greater than 25 dB hearing level.
The investigators evaluated various demographic and health factors, including:
-
Age
-
Self-reported sex and race
-
Socioeconomic position (based on education and occupation)
-
Noise exposure history
-
Medical conditions (diabetes, obesity, and cardiovascular conditions)
-
Smoking history
-
Number of comorbid conditions.
Significant Associations
In multivariable models for the entire sample, older age (odds ratio [OR] = 1.10 per year;, 95% confidence interval [CI] = 1.09–1.12), male sex (OR = 2.54, 95% CI = 1.94–3.32), lower socioeconomic position (low: OR = 1.72;, 95% CI = 1.27–2.33), and noise exposure (OR = 1.30;, 95% CI = 1.00–1.69) were associated with a higher risk of hearing loss, whereas Black race was associated with a lower risk (OR = 0.51, 95% CI = 0.38–0.70).
Factors associated with hearing loss differed substantially between demographic groups:
-
Among White male individuals, only older age remained significantly associated with hearing loss in multivariable models.
-
Among White female individuals, older age and low socioeconomic position remained significant factors.
-
Among Black male individuals, only older age showed a significant association.
-
Among Black female individuals, older age and low socioeconomic position increased the risk of hearing loss, while cardiovascular conditions were unexpectedly associated with a lower risk.
Audiometric Patterns
The investigators also revealed distinct patterns in audiometric thresholds. Across the groups, the mean thresholds were similar at frequencies 0.25 to 1.0 kHz. At 2.0 kHz and higher, White male individuals showed poorer and Black female individuals showed better thresholds, with Black male individuals and White female individuals in between.
These patterns held after stratifying by age (younger than 65 years vs 65 years or older) and were characteristic of age-related hearing loss, with thresholds being poorer in the high frequencies and better in the low frequencies.
Implications for Public Health
The investigators noted that different factors may contribute to hearing loss across demographic groups, suggesting the need for tailored interventions. "Noise exposure, a well-known risk factor for hearing loss, was associated with hearing loss in age-adjusted models among White male individuals but not among other groups, despite a similar prevalence of noise exposure among Black and White male individuals," the study authors remarked.
The study concluded that hearing loss represents "an important public health concern that could be addressed through tailored interventions to reduce its risk across populations."