Foundational Approaches to Advancing Hearing Health Equity: A Primer in Social Epidemiology.
Carrie L Nieman, Jonathan J Suen, Lorraine T Dean and 1 others
PMID 35724250WHAT IT FOUND
Hearing loss disparities are driven by social factors like racism and poverty, not just biology.
Clinicians should stop treating race as a biological proxy and instead assess social determinants like access and stigma to tailor care.
Key findings
01Race should not be treated as a biological construct in hearing health; differences in hearing loss prevalence are better explained by social factors and skin pigmentation rather than genetic race categories.
02Social determinants such as socioeconomic position, place, and racism significantly influence hearing health outcomes and access to care, often more than individual biological factors.
03Clinicians can improve equity by monitoring care outcomes by race and socioeconomic status, recognizing historical mistrust, and ensuring practice environments are accessible to diverse populations.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a narrative review and primer, not a systematic review or meta-analysis, so it does not provide pooled effect sizes or a comprehensive search of all literature. The recommendations are largely theoretical and based on frameworks from social epidemiology, with limited direct evidence on the effectiveness of specific clinical interventions for hearing health equity. The paper focuses primarily on US and global data, which may not fully capture local contexts for all clinicians.
Declared interests
The paper is supported by the National Institutes of Health (N.I.H., Extramural). No other conflicts of interest are reported.
The easy way to misread this
Do not use this paper to support biological explanations for racial differences in hearing loss. The review explicitly states that race is a social construct and that differences in prevalence are better explained by social factors and pigmentation, not genetics.