Hearing Loss Prevalence in the United States FREE

The prevalence of hearing loss in the US population has been estimated from self-reported data¹ or in age-restricted cohorts.² These estimates may not accurately reflect the true burden of hearing loss in the United States. We estimated the overall prevalence of audiometric hearing loss among all individuals (age ≥12 years) in the United States using data from a nationally representative data set and with a definition of hearing loss recommended by the World Health Organization (WHO).

We analyzed data from the 2001 through 2008 cycles of the National Health and Nutritional Examination Surveys (NHANES), an ongoing epidemiological survey designed to assess the health and functional status of the civilian, noninstitutionalized US population.³ Air conduction pure-tone audiometry was administered to all participants aged 12 to 19 years from 2005 through 2008 (n = 3143), a half sample of all participants aged 20 to 69 years from 2001 through 2004 (n = 3630), and all participants 70 years and older from 2005 through 2006 (n = 717). Audiometry was performed in a sound-attenuating booth according to established NHANES protocols. A speech-frequency pure-tone average (average of hearing thresholds at 0.5, 1, 2, and 4 kHz) of 25 dB HL (hearing level) or greater in both ears was defined as hearing loss per WHO criteria,⁴ and this is the level at which hearing loss begins to impair communication in daily life. Hearing loss prevalence was estimated by age decade, sex, and the 3 largest categories of race/ethnicity (non-Hispanic white [white], non-Hispanic black [black], and Mexican American or other Hispanic [Hispanic]). There were insufficient individuals from other racial/ethnic groups to derive reliable age-stratified estimates. However, individuals from all racial and ethnic categories were included in estimates of overall prevalence. US population counts were estimated using the midpoint of population totals in each cycle and averaged across combined cycles when appropriate. We accounted for the complex sampling design in all analyses by using sample weights according to National Center for Health Statistics (NCHS) guidelines.

We estimate that 30.0 million or 12.7% of Americans 12 years and older had bilateral hearing loss from 2001 through 2008, and this estimate increases to 48.1 million or 20.3% when also including individuals with unilateral hearing loss (Table). Overall, the prevalence of hearing loss increases with every age decade. The prevalence of hearing loss is lower in women than in men and black vs white individuals across nearly all age decades.

For individuals 12 years and older in the United States, nearly 1 in 8 has bilateral hearing loss, and nearly 1 in 5 has a unilateral or bilateral hearing loss. These are the first national estimates of hearing loss in the US population based on audiometric data and a large, well-characterized representative sample. Previous national estimates based on self-reported data¹ and age-restricted cohorts² have been lower, in a range of 21 to 29 million. Other estimates of hearing loss prevalence have come from population-based cohorts⁵ that are not representative of the US population. While the overall risk of hearing loss may be decreasing over time,^6- 7 the prevalence of hearing loss is expected to rise because of the aging of the population. Research is needed to understand the impact of hearing loss on cognition⁸ and other functional domains and the role of aural rehabilitative strategies in possibly mitigating these effects.