(437) Rurality Effect on Michigan Newborn Hearing Screening

Introduction: Newborn hearing screening is important for early identification of hearing loss in the infant population. Delays in diagnosis can lead to irreversible long-term speech, language, and cognitive effects. The purpose of this study being to examine how rurality affects patients failing a newborn hearing screen.

Methods: Patients in the Michigan Department of Health and Human Services (MDHHS) Newborn Hearing Screening database that failed or did not receive their initial screen from 2015-2020 were evaluated. Using the U.S. Department of Agriculture Rural-Urban Continuum Codes (RUCC), patients were assigned a 1-9 code based on the population of their zip code, with 1 being the most urban and 9 being the most rural. Multiple variables, including follow up screening, final diagnosis, and reason for not screening were evaluated and compared using the rurality codes.

Results: There were 34,928 patients initially identified that had failed or not gotten a newborn hearing screen during the period. There was no difference in rurality between those that had a follow-up screen and those that did not, with mean RUCCs of 2.2 and 2.1, respectively (p=0.052). There was a significant difference in those that refused screening, with a mean RUCC of 4.2, and those that had a failed initial screen having a mean RUCC of 2.1 (p < 0.001). Similarly, those with equipment failure had a higher mean RUCC, 2.8, compared to those that had screening completed (p < 0.001).

Conclusions: More rural areas are more likely to refuse a newborn hearing screen as well as have equipment failure options. There was no difference in rurality scores of those that had a follow up screen after a failure and those that did not.