(261) Inclusive Soundscapes: Investigating access to pediatric cochlear implantation in Memphis

Monday, October 2, 2023

2:45 PM – 3:45 PM East Coast USA Time

Has Audio

Presenting Author(s)

ST

Sofia Torres-Small

Medical Student
University of Tennessee Health Science Center, College of Medicine
Memphis, Tennessee, United States

Co-Author(s)

CW

Christina N. Ward, MD, MS

Resident Physician
University of Tennessee Health Science Center
Memphis, Tennessee, United States
AT

Ana Tomescu, n/a

University of Tennessee Health Science Center, College of Medicine, United States
Sarah E. Warren, PhD, AuD, MPH

Assistant Professor
University of Memphis
Memphis, Tennessee, United States
CM

Charles B. MacDonald, MD

University of Tennessee Health Science Center, Department of Otolaryngology-Head & Neck Surgery, United States
RY

Robert J. Yawn, MD, MBA

University of Tennessee Health Science Center, USA

Senior Author(s)

CR

Celine C. Richard, MD, PhD

Faculty
University of Tennessee Health Science Center
Columbus, Ohio, USA

Disclosure(s):

Sofia Torres-Small: No relevant relationships to disclose.

Introduction: The presence of health-promoting options in our homes, neighborhoods, and schools significantly impacts our well-being, healthcare access and healthcare management choices. This study aimed to assess how race, social vulnerability index (SVI), and maternal age at birth influence pediatric cochlear implant (CI) access, and we hypothesized that patients of color with higher SVI and younger mothers would face an increased risk of delays in diagnosis and CI acquisition, as well as lower daily CI usage.

Methods: This study was a retrospective cohort analysis of individuals aged 0 to 18 who received a CI at our center between the years 2000 and 2022. SVI data from 2020 was obtained from the Center for Disease Control and Prevention. One-way analysis of variance was used to determine the association between our variables of interest. Our independent variables included race, SVI, and maternal age, and our dependent variables were age at hearing loss diagnosis (AHL), time from diagnosis to CI acquisition (TDI), and average daily CI use (ADU).

Results: A total of 303 patients were included in our study, of which 43% were Black and 50% were White. Patients from the highest to lowest SVI quintiles comprised 31%, 25%, 18%, 10%, and 14% of our sample, respectively. Race was significantly correlated with SVI (p < 0.001), with a mean SVI of 0.70 (± 0.26) and 0.49 (± 0.27) for Black and White patients, respectively. SVI was significantly associated with AHL (p = 0.0162) and TDI (p = 0.036). Sex was also significantly associated with TDI (p < 0.001).

Conclusions: Over 50% of the pediatric patients who receive a CI at our center live in areas with an SVI greater than 0.6, and the average SVI for Black patients is significantly higher than for White patients. SVI was found to be associated with AHL and TDI, with those in the most vulnerable category presenting with the longest diagnostic and acquisition delays. Interestingly, sex was also significantly associated with TDI, with males receiving a CI faster on average than females. We are currently conducting in-depth analyses to support the development of intervention programs for those in need in our community.