U.S. Population Data on Hearing Loss, Trouble Hearing, and Hearing-Device Use in Adults: National Health and Nutrition Examination Survey, 2011-12, 2015-16, and 2017-20.
Larry E Humes
PMID 37016920WHAT IT FOUND
About 85% of US adults with hearing difficulties have unmet needs.
Self-reported trouble hearing predicts device use far better than audiograms. Older adults under-report hearing loss compared to their actual audiometric impairment, while younger adults over-report it.
Key findings
01Approximately 85% of US adults with hearing difficulties have unmet hearing healthcare needs.
02Self-reported hearing trouble is a much stronger predictor of hearing aid use than audiometrically measured hearing loss.
03There is a significant mismatch between self-perception and clinical measurement: adults under 60 often report trouble without audiometric loss, while those over 70 often have loss without reporting trouble.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Device use data relied on self-report and recollection, which may be inaccurate. The definition of hearing loss was specific to the WHO PTA4 ≥ 20 dB HL criterion; other definitions yield different prevalence rates. The study did not capture 'hidden hearing loss' or sub-clinical deficits that do not affect pure-tone thresholds. Prevalence estimates varied by age group due to differences in audiometric testing availability across NHANES cycles (e.g., 2017-20 only tested those 70+).
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research.
The easy way to misread this
Do not assume that a normal audiogram means a patient has no hearing disability. Many younger adults report significant hearing trouble despite normal thresholds, and self-reported trouble is a stronger driver of device use than clinical loss. Conversely, do not assume older adults with significant audiometric loss are aware of or bothered by their impairment, as they often under-report difficulty.