Black older Americans have lower prevalence of hearing loss than their white peers

Black Americans 65 years and older have much better hearing than their White counterparts, according to a recent study published in the Journal of Speech, Language, and Hearing Research.

In 2016 and 2017, 15.4% of Non-Hispanic White older adults in the US reported serious hearing loss. In contrast, the prevalence of this self-reported condition among Non-Hispanic Black respondents was almost half that amount: 9.4% and 9.0% in 2016 and 2017 respectively.

The odds of hearing loss are 91% higher in Non-Hispanic White participants compared to Non-Hispanic Black participants when adjustments were made for age, sex, household income, and educational levels. In other words, there is almost double the likelihood of hearing loss in the Non-Hispanic White population.

"The racial/ethnic difference in hearing problems is intriguing," says corresponding author, Dr. Esme Fuller-Thomson, director of University of Toronto's Institute of Life Course and Aging and professor at the Factor-Inwentash Faculty of Social Work.

"Hearing loss is one of the most common chronic problems affecting older adults. Those with hearing loss tend to have lower quality of life and a higher prevalence of depression and hospitalization. Understanding the causes and drivers behind the racial/ethnic differences in hearing loss can help us design better preventative strategies as the Baby Boom cohort ages."

Previous studies investigating the link between race/ethnicity and hearing focused on community-dwelling older Americans. However, less attention has been directed to institutionalized, and potentially frailer, Americans, which would generate a more holistic understanding of hearing loss among the older adult population.

The gold standard for research is that results from one sample are replicable in a different, independent sample. This study was first conducted in the 2017 wave of the American Community Survey and was then repeated with data from the 2016 American Community Survey. Results from both studies were very similar, providing greater support for the findings.

Each wave of the survey engaged a nationally representative sample of approximately half a million American respondents aged 65 and older, including both those who lived in institutions, such as long-term care homes, and those who were living in the community. While the study's observed racial/ethnic difference in hearing loss among older adults is in keeping with previous studies that used smaller samples of community-dwelling adults, one surprising finding emerged.

"Interestingly, we found that among males, Non-Hispanic Black Americans have a prevalence of hearing loss that is similar to Non-Hispanic White Americans who are 10-years younger," says the study's first author, ZhiDi Deng, a pharmacy student at University of Toronto.

"To put this into perspective, Non-Hispanic Black Americans who are 75-84 years old had a hearing loss prevalence of roughly 14%. This is the same prevalence we saw in Non-Hispanic White Americans who are 65-74 years old," says co-author, Senyo Agbeyaka, who is now a social worker at the University Health Network.

The authors proposed several potential explanations for the observed findings, including racial/ethnic differences in diet, smoking habits, noise exposures, bone density and cochlear melanin content. However, the dataset used by this study and earlier research does not allow exploration of the potential mechanisms causing the differences in hearing loss.

"More research is needed to understand the extraordinary differences in hearing, including the 10-year difference in hearing prevalence between Non-Hispanic Black and White males," says Fuller-Thomson.