By David H. Kirkwood
LONDON–A report issued July 9 by the British Commission on Hearing Loss further confirms the enormous economic toll that untreated hearing loss takes on those with the condition–as well as the rest of society. It also explores why in the United Kingdom, where hearing aids are free, only 20% of the 10 million people with hearing loss have them and, of those, only, 70% wear them regularly.
According to the Final Report of the commission, which was established by the International Longevity Centre-UK (ILC-UK), a think tank affiliated with University College London, hearing loss costs the British economy almost 25 billion pounds (about $43 billion) a year in lost output.
ECHOES AMERICAN FINDINGS
These figures are somewhat similar (when the difference in population size is factored in) to those reported by the Better Hearing Institute (BHI) in 2007. In his article, Sergei Kochkin, PhD, who was then executive director of BHI, calculated that the 24 million Americans with unaided hearing loss suffered $100 billion a year in reduced income because of their disability. That resulted in a loss to the nation’s coffers of more than $18 billion in income tax revenues.
Kochkin found that hearing loss reduced average household income by up to $12,000 a year depending on the degree of hearing loss. However, using hearing aids reduced the amount of lost income by half.
A CALL TO ACTION
In her foreword to the report, Baroness Sally Greengross, chair of the commission and chief executive of ILC-UK, asserts, “For too long, hearing loss has been ignored, overlooked, and disregarded despite the millions of people experiencing hearing loss and the devastating consequences that it can have on individuals, their families, and society as a whole.”
She warns that unless action is taken, the problem in the UK will become worse, as by 2031, nearly 20% of the population will have hearing loss. Therefore, she says, “We must get hearing loss up the agenda and ensure that more people are able to access good hearing care services, and that society as a whole, is ready for hearing loss.”
The report emphasizes the “devastating implications for the individual with hearing loss as well as for their family.” It notes research showing that those with hearing loss are more likely to become socially isolated and have mental and physical health problems, and it cites “a growing body of research showing an association between hearing loss and dementia.”
However, the commission adds, “The devastating impacts of hearing loss for the individual and for society could be avoided if there was better support for those with hearing loss–including improved provision, take-up and use of hearing aids.”
WHAT’S THE PROBLEM?
The commission’s report goes on to discuss why so few people with hearing loss are getting help and what needs to be done to improve the situation. While the study looks only at the UK, many of its findings are relevant to other countries, such as the US, where the great majority of people with hearing loss do not address it. Among the factors that the report identifies are the following:
• The slow onset of hearing loss. “Partly for this reason, it takes on average 10 years before someone with hearing loss recognizes that they have it and seeks support.
• The stigma associated with hearing loss acts to prevent people from seeking help.
• Misperceptions about what hearing loss represents and about the nature of the available interventions.
• Hearing loss is seen as a natural and inevitable part of the aging process.
FLAWS IN THE SYSTEM
The Commission on Hearing Loss goes on to point out flaws in the existing hearing health system and to suggest ways to improve it so that more people will get help for their hearing loss. Under the current National Health Service (NHS), to get a hearing test and be eligible for a hearing aid, individuals must be first referred by their GP. Yet, the report says, “Evidence suggests that 45% of people who go to their GP to seek help for their hearing loss do not get referred on.”
It adds, “There is a fundamental question about whether the system should be opened up to ensure less barriers before having a hearing test.”
The report continues, “The entire process of having a hearing aid fitted can be overly clinical and often takes place within hospital settings following referral by the GP. While hospitals undoubtedly have a role to play in supporting the needs of those with hearing loss, there is a suggestion that the entire process of intervention places too much emphasis on the medical nature of hearing loss, which helps to reinforce the stigma associated with it.
“A person-centered approach, emphasizing the needs and experiences of the individual, and providing holistic support and advice, would allow more emphasis on the social impacts of hearing loss.”
The commission offers a number of recommendations, including the following, on how to reach more people in need of hearing care.
To address the “urgent need to detect hearing loss earlier,” create a national screening program for adults and build a test for hearing loss into health check-ups for those likely to be at risk of hearing loss.
“Open up the system” so fewer people drop out before seeing an audiologist. Develop “alternative models” such as self-referral to see what works best. Provide hearing service in more flexible ways to match people’s preferences. This may include expanding community-based hearing care services provided by the public, private, and voluntary sectors, as well as home visits.
Ensure that every person fitted with a hearing aid receives a face-to-face follow-up appointment and ongoing aftercare whenever needed. “These should be provided in accessible and convenient ways.
The report concludes: “We are in need of an overarching strategy to tackle hearing loss that does not just cut across government departments but involves the multitude of sectors and stakeholders involved with hearing loss in the UK. By integrating and improving services, and avoiding more costs in the longer term, this will help to alleviate continuing funding pressures on central and local government budgets.
“As the UK continues to age, it is crucial we face these questions today and ask how we can deliver better support for the increasing number of people with hearing loss.”