by Daniel Fink, MD, Chair, The Quiet Coalition
This viewpoint article in the latest issue of The Journal of the American Medical Association by Frank Lin, MD, PhD, and colleagues at Johns Hopkins University School of Medicine and the Bloomberg School of Public Health, makes the case for expanding Medicare coverage of audiology services to help older Americans with hearing loss.
Dr. Lin and his colleagues are the leading researchers in the epidemiology of hearing loss. They have published a series of reports documenting the prevalence of hearing loss in older Americans and showing that hearing loss is strongly correlated with social isolation, depression, falls, accidents, and other conditions, all of which are associated with increased mortality in older people.
What’s missing from the article? Two things.
First, the report doesn’t explain that devices, whether they are hearing aids or over-the-counter personal sound amplification products, just don’t work as well as preserved normal hearing. The “elephant in the room” for hearing health care is the 30-40% non-usage rate among those who have obtained hearing aids, because in real-life situations, e.g., noisy stores or restaurants, these just don’t work as well as normal ears. The analogy I use is dentures. It really doesn’t matter if one has to have dentures made by a dentist and prosthodontist, or if one could walk into a drugstore or warehouse store and buy them. One’s natural teeth work better.
Second, the report doesn’t discuss the prevention of hearing loss. Continuing the dental analogy, it takes a lifetime of care, with daily brushing and flossing, regular cleanings, and dental work to keep one’s natural teeth one’s entire life. In contrast, avoiding noise-induced hearing loss is easy and costs nothing or very little–simply avoid exposure to loud noise. And if you can’t, wear hearing protection.
Remember: if it sounds too loud, it IS too loud.
Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.