Hearing Loss Hits Rural America Hardest, New Study Finds

In a new study published this week in The Lancet Regional Health – Americas reveals stark geographic divides in hearing loss prevalence across the United States. Researchers at NORC at the University of Chicago estimated hearing loss rates not just nationwide, but also at the state and county levels for the first time.

The results show hearing loss impacts rural communities more significantly than urban areas.

Rural Communities at Higher Risk for Hearing Loss

Analyzing data from over 20 sources, including federal health surveys, the study defined hearing loss as mild, moderate, or any level of loss in both ears. Nationally, an estimated 37.9 million Americans have bilateral hearing loss, with higher rates associated with older age, male gender, and white race.

But drilling down to the county level, clusters of heightened hearing loss emerged in states like West Virginia, Wyoming, and Arkansas. Meanwhile, lower prevalence appeared in counties surrounding cities like Washington DC, Los Angeles, and Chicago. Though reasons for this urban-rural divide are not entirely clear, audiology experts suggest occupational and recreational noise exposure may drive more hearing damage in rural settings.

In rural areas, there are likely fewer large employers with hearing conservation programs and popular pastimes such as hunting, motorsports, and woodworking often lack consistent hearing protection measures.

In urban environments, public transit commute times may limit hazardous noise durations. But rural Americans frequently have longer noise exposure from machinery, firearms, and vehicles. With less access to regular hearing healthcare, prevention and early treatment lag in these communities.

Raw prevalence of any hearing loss by U.S. County. Click here to visit the interactive map

Men at Highest Risk

Beyond geography, researchers confirmed previously identified demographic factors correlate to higher hearing loss rates. Men over age 35 showed significantly more hearing impairment than women, possibly due to more occupational noise hazards. Hearing loss also increased dramatically after age 65 across all groups.

Among racial categories, non-Hispanic whites had the highest prevalence.

While the study could not pinpoint precisely why rural counties are hardest hit, the granular county-level data provides an important jumping off point for further research. The maps can help public health officials better target at-risk communities for interventions like free screenings and hearing protection giveaways.

For individuals, audiologists emphasize paying attention to muffled conversations and difficulties hearing in noisy environments as potential signs of early hearing loss. Seeking assessment from a hearing healthcare provider is recommended, especially for those over 50. Consistent use of hearing protection when exposed to loud machinery, power tools, sporting events, and concerts can also help curb damage.

The researchers expressed hope that their study would raise awareness of hearing health disparities affecting millions of people in the US. With accurate prevalence data, efforts can now be focused on improving access to prevention and treatment in areas where it’s most needed. They emphasized the importance of protecting hearing as it connects individuals to their communities and should be a priority for all.