A high proportion of older people with hearing aids, especially those with lower incomes, report having trouble hearing and difficulty accessing hearing care services, according to a study from researchers at Johns Hopkins Bloomberg School of Public Health.
The researchers, whose analysis is based on Medicare survey data and was published in the January issue of Health Affairs, suggest that the federal government expand Medicare and/or Medicaid coverage of hearing care services.
The study of 1,133 Medicare participants found that having a hearing aid that functioned well appeared to depend greatly on income level. Among low-income Medicare beneficiaries dually eligible for Medicaid, 27 percent of respondents reported having a lot of trouble hearing with a hearing aid. By contrast, just 11 percent of those in the highest income category—at least four times the poverty level—reported a lot of hearing-aid difficulties. In all, 442, or 39 percent, of the 1,133 hearing-aid users reported using hearing care services in the previous year.
“This study highlights the fact that hearing aids alone don’t necessarily improve hearing—hearing care services are important too, but there are barriers that prevent many people from accessing those services,” says study co-author Dr. Nicholas Reed, who is a member of the core faculty at the Bloomberg School’s Cochlear Center for Hearing and Public Health and is also an assistant professor of audiology in the department of otolaryngology—head and neck surgery at the Johns Hopkins University School of Medicine. The paper’s lead author is Dr. Amber Willink, assistant scientist in the Bloomberg School’s department of health, policy and management, with co-author Dr. Frank Link, director of the Bloomberg School’s Cochlear Center.
Two-thirds of U.S. adults over the age of 70 experience hearing loss, which reduces quality of life and has been linked to depression, dementia and a worsened risk of falls. Yet most older adults do not wear hearing aids. The devices and the audiology services needed to fit them are specifically excluded from Medicare coverage. Medicaid does provide some coverage for lower-income elderly people with hearing loss, but that coverage is far from comprehensive even in the 28 states that have it.