Abstract
Hearing loss is increasingly recognized as a chronic disease that warrants treatment.
Depression, social isolation, loneliness, and poorer cognitive performance have all
been linked to untreated and undertreated adult-onset hearing loss. A significant
subset of the patient population with hearing loss is inadequately rehabilitated by
hearing aids alone and may benefit from cochlear implantation. Yet, it is estimated
that less than 10% of those who qualify have received implants to date. A national
survey was conducted online in November and December 2021. Subjects were identified
using Dynata panelists and river sampling. Enrollment occurred on a rolling basis.
Upfront sample management techniques were used to control the distribution, balancing
the respondent cohort to the 2018 U.S. Census on age, household income, sex, marital
status, household size, race/ethnicity, and education. Among 15,138 adult respondents
with a mean (SD) age of 51 (17) years (54% female), only 10% reported being very familiar
with cochlear implants, and 31% of those with hearing difficulty reported that they
have “never heard” of a cochlear implant. Females were statistically significantly
more likely to report some degree of familiarity with cochlear implants than men (34
vs. 26%; p < 0.01). The greatest familiarity with cochlear implants was observed among those
aged 35 to 44 years (18% reporting “very familiar”), whereas only 9% of those aged
65 to 74, 10% aged 75 to 84, and 8% ≥85 reported being very familiar (p < 0.01). Those identifying as White/Caucasian were statistically significantly more
likely to report familiarity with cochlear implants than those identifying as Black/African
American and Hispanic/Latino/Spanish (33 vs. 56 vs. 50% responding that they had “never
heard” of cochlear implants; p < 0.01). Among adults with hearing difficulty, nearly 80% report having never talked
with a medical or hearing care professional about cochlear implants. Limited cochlear
implant awareness likely influences its widespread underutilization across the United
States. Sex, age, and race disparities compound these issues among men, the Medicare-aged
population, and those identifying as Black/African American and Hispanic/Latino/Spanish.
Keywords
hearing loss - cochlear implant - adults - awareness - utilization - population -
race - gender - age - disparity
