Associations and trends in recency of hearing tests in the United States

Abstract

Objective: To identify associations and trends in recency of hearing test in aggregate and race-specific fashion.

Methods: Adults (>20 years) in the United States participating in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2012, 2015-2016, and 2017-2020.

Results: 10,751 participants with 9130 audiograms, were included for analysis. Less severe HL (p = 0.005), better self-perceived hearing (p < 0.001), and shorter time in the United States (p < 0.001) were associated with a longer interval since their last hearing test. On multivariable analysis, only Asians had a longer time since their last hearing tested compared to whites (OR = 1.62, p = 0.005). Better self-perceived hearing was associated with a longer time since the last hearing test in Blacks (p = 0.019) and Hispanics (p = 0.006), while HL severity was not (Black, p = 0.203; Hispanic, p = 0.872). Speaking mostly a non-English language (OR 1.39, p = 0.006) was associated with a longer interval for Asians, while speaking mostly Spanish at home was not for Hispanics (OR 1.29, p = 0.128). Compared to 2011-2012 rates, all races (p < 0.001) had increased rates of recent hearing tests by 2017-2020 except for Blacks (p = 0.664).

Conclusions: Despite adjustments for HL, the time since last hearing test differed by race. Addressing factors associated with recency of hearing tests, such as discordance between objective and self-perceived HL and language barriers, may improve identification of HL in racial minorities.

Keywords: Audiogram; Audiology; Hearing loss; Hearing test; Racial disparities.