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Otology/Neurotology

Gender and Socioeconomic Disparities in Nationwide Sensorineural Hearing Loss Cohort

Sunday, October 1, 2023
5:06 PM - 5:12 PM East Coast USA Time
Location: 104BC

    Presenting Author(s)

  • Luis E. Cortina, BS

    Medical Student
    Harvard Medical School
    Cambridge, MA, United States

    • Co-Author(s)

  • Andrew E. Amini, BS

    Medical Student
    Harvard Medical School
    weston, MA, United States

    • Senior Author(s)

  • James G. Naples, MD

    Assistant Professor
    Beth Israel Deaconess Medical Center/ Harvard Medical School
    Needham, MA, United States

Disclosure(s):
Luis E. Cortina, BS: No relevant relationships to disclose.
Andrew E. Amini, BS: No relevant relationships to disclose.
James G. Naples, MD: No relevant relationships to disclose.
Introduction: Hearing loss can lead to several undesirable effects, but few studies have explored how hearing loss impacts equity in healthcare access and utilization for low-income and female patients. Here, we aim to explore these associations.

Methods: This cross-sectional study included all patients with a diagnosis of sensorineural hearing loss (SNHL; ICD-10 H90.3) from the National Institutes of Health All of Us Research Program. A subset of 8,875 patients (48.3% male, mean age 69) who participated in the Health Care Access and Utilization survey were studied. Multivariate logistic regressions were used for statistical evaluation, using gender and income as independent variables.

Results: After adjusting for covariates, female participants were more likely than male participants to report difficulty affording prescribed medications (OR 1.7, 95% CI 1.4 – 2.0, p < 0.0005), medical specialists (OR 1.4, 95% CI 1.2 – 1.8, p < 0.005), and to experience delayed medical care to elderly care (OR 2.6, 95% CI 1.7 – 4.1, p < 0.0005), work (OR 1.7, 95% CI 1.4 – 2.2, p < 0.0005), and feeling nervous (OR 1.7, 95% CI 1.4 – 2.1, p < 0.0005). Additionally, female participants were less likely than male subjects to ask for health care opinions (OR 1.2, 95% CI 1.1 – 1.6, p < 0.005) and to undergo a hearing aid examination and selection (OR 6.4, 95% CI 5.3 – 7.8, p < 0.0005). Low income ( < $25,000) was also associated with feeling misunderstood (OR 2.3, 95% CI 1.6 – 3.1, p < 0.0005) and lack of respect (OR 3.2, 95% CI 2.1 – 4.9, p < 0.0005) by healthcare professionals compared to participants of higher income.

Conclusions: This work suggests that patients of female gender and lower socioeconomic status have significantly higher odds of reporting barriers to healthcare access. Additionally, these factors were associated with reports of discomfort in discussing social issues with their healthcare provider. Therefore, physicians should consider the impact of gender and socioeconomic status on access and utilization of healthcare in patients with SNHL to promote equity in care.