Awareness

Under Normal Circumstances

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By Morgan Leppla

March is Disability Awareness Month. In honor of this important awareness month, Hearing Health Foundation is raising awareness and celebrating all of our different abilities and doing our part to reduce the stigma of living with hearing loss and its associated disorders.

Whether we like it or not, people compare themselves to others. Maybe contemporary culture brings it out in us, or perhaps that impulse is rooted in Darwinism ideology of survival of the fittest, reminding us of competitive advantages. Who is taller, more intelligent, faster?

Possibly, it also has to do with how we conceptualize normalcy. In the mid-1800s, Belgian statistician Adolphe Quetelet introduced the idea of “l’homme moyen” (average man) when he realized that human traits are distributed over a bell curve. So the average man would have the mean of all human traits in a single abstract person.

“Normal” entered English vocabulary in 1840 and has since been used to describe bodies and behavior. However, before society focused on the “the norm” it concerned itself with “the ideal.” Take the most coveted parts of bodies and traits that exist and combine them, and that would be the ideal person.

So why is this distinction meaningful? Because every living person is non-ideal, since by definition it cannot exist in one person, whereas people (bodies and traits) can be “normal.” On the contrary, normalcy is attainable on an individual level. And society’s reactive effect to the creation of normal humans was the production of their dichotomous counterparts: the extremes or deviants at the tail ends of the bell curve, the abnormal.

However, a collision of the normal and the ideal occurred when English statistician Francis Galton decided to rank human traits, created quartiles on an intelligence bell curve, and ordered them one to four. One was lowest intelligence and least desirable while four was highest intelligence and most desirable. He reoriented the human ideal using the norm. And now, I would say, it is “normal” to want to be the smartest, most athletic, most attractive, etc.?

The latter half of the 19th century employed pseudo-empirical justifications for describing how bodies should be in fairly clear terms. And to focus on distribution of differences warps the way society approaches normalcy as a concept. It allows us to draw lines where perhaps they ought not exist.

Thus we arrive at the construction of disability. Anyone who does not physically look like others or does not act like others is perceived as deviant or abnormal because they are at the wrong end of the bell curve. Beyond the initial construction of the human normal, barriers that are literal, educational, communicational, and attitudinal further maintain “disability” since nonexistent or poor accommodations along with stigma exacerbate “disabling” differences.

Hearing Health Foundation is encouraging everyone to think about how “norms” have molded our preferences and attitudes and whether that translates to treating people differently. Life may be more arbitrary than you think, and more can be going on than what meets the eye.

HHF is committed to spreading awareness of hearing loss and its associated disorders as well as reducing the stigma attached to them. If you’d like to share your story and experiences with our community, please email us at info@hhf.org.

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A Healthy Heart Could Mean Better Hearing Health

By Frankie Huang

In honor of American Heart Month in February, Hearing Health Foundation wants to shine light on the link between heart disease and hearing loss. According to the Centers for Disease Control and Prevention, 610,000 Americans die from heart disease each year, making it the leading cause of death for men and women in the U.S.

Heart disease is linked to or causes numerous health issues, including hearing loss. One study suggests that low-frequency hearing loss may be able to predict cardiovascular health. Using an audiogram, researchers were able to determine the probability of cardiovascular disease in men and women. The study found that there was a correlation of heart attacks in men, and a correlation of claudication (pain caused by too little blood flow) in women.

High blood pressure can also be a contributing factor to developing hearing loss, since the inner ear is sensitive to blood flow. High blood pressure damages blood vessels and increases the risk of plaque buildup in the arteries, making it harder for blood to flow throughout the body. In other words, inadequate blood flow and nerve damage in the inner ear may lead to irreversible hearing loss.

A common cause of heart disease and hearing loss is smoking. Smoking increases blood pressure and plaque buildup, and causes hardening of the arteries, all of which decreases blood flow to the organs and other parts of the body. The effects of smoking damages the cardiovascular system, boosting the risk of hearing loss. Additionally, cigarettes contains nicotine, disrupting the neurotransmitters in the auditory nerve (which tell the brain which sound you are hearing) and preventing the brain to accurately interpret sound. Cigarette smoke contains many harmful chemicals that are believed to be ototoxic (toxic to the ear) that may damage hair cells.

There are a variety of ways to prevent heart disease and cut your risk for hearing loss. Eating healthy and incorporating moderate exercise into your daily life can drastically improve your health. Include more fish in your diet: Salmon, mackerel, and herring are high in the omega-3 fatty acids that help reduce high blood pressure and prevent plaque buildup, so you can decrease your overall risk of hearing loss.

Remember, a healthy heart leads to better hearing health.

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When It's Not Just Hearing Loss

By Morgan Leppla & Laura Friedman

This year Autism Sunday, an international day to raise awareness of autism spectrum disorder (ASD), is on Feb. 12.

Did you know that one third or more of pediatric hearing loss cases overlap with another condition? This may sometimes be ASD, making treatment and management of co-occurring conditions a challenge.

In a 2007 report in the Journal of Deaf Studies and Deaf Education, British researcher Lindsay Edwards, Ph.D., cites an estimate that 30 to 40 percent of children with hearing loss have co-occurring conditions that could prohibit them from forming language, speech, and sociocognitive skills. But despite this large percentage, there is little research on hearing loss that occurs with other disorders. What research there is has shown the benefit of cochlear implantation for children with additional needs (such as physical or learning disabilities), and the difficulties of language acquisition and development for 3-year-olds with developmentally related conditions such as ASD, cerebral palsy, or Down syndrome.

One silver lining is that the fact that 30 to 40 percent of pediatric hearing loss may occur with other conditions may prove helpful in predicting future disorders. A July 2016 Autism Research paper suggests that a noninvasive measure of otoacoustic emissions in the inner ear—a common hearing test for infants, who are preverbal—may help identify the risk of ASD at an early age, accelerating treatment. Study author Anne Luebke, Ph.D., of University of Rochester Medical School, found that children with ASD often have trouble hearing a frequency range (1–2 kHz) that is important for understanding speech. The range includes sounds for the meaning-conveying consonants S-, H-, and F-.

Scientific conclusions can help shape future research, but cannot illustrate daily life for families with children with co-occurring conditions. Dual diagnoses make unlocking any child’s learning style challenging, but reviving research and upgrading professional training are essential tools in order to advocate for and successfully educate children with co-occurring conditions.

If you’re interested in funding research related to diagnosing and treating co-occuring disorders, such as hearing loss and autism, please consider donating today: hhf.org/donate or contact us at development@hhf.org.

This blog was adapted from an article original appearing in Hearing Health magazine’s Fall 2016 issue. For references in this story, see hhf.org/fall2016_references.

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Noise-Induced Hearing Loss Affects More Than 50% Not in Noisy Jobs

By Yishane Lee

The Centers for Disease Control and Prevention (CDC) made an announcement Feb. 7 on the dangers of noise-induced hearing loss (NIHL). Among the many statistics cited, the CDC says:

  • 40 million U.S. adults ages 20 to 79 have NIHL

  • More than half (21 million) with hearing damage do not have noisy jobs

  • One in four U.S. adults who say they have good or excellent hearing actually show hearing damage

  • Hearing loss is the third most common chronic health condition in the U.S.

  • People report hearing loss at a rate nearly double of those reporting diabetes or cancer

The CDC says its latest Vital Signs report, using data from more than 3,500 hearing tests in the 2012 National Health and Nutrition Examination Survey (NHANES), shows “much of this [hearing] damage is from loud sounds encountered during everyday activities at home and in the community,” such as using a leaf blower or going to a loud concert without hearing protection. Nearly three-quarters of those who are exposed to loud noises never or rarely use hearing protection, the report says.

According to the press release, CDC researchers “found that 20 percent of people who reported no job-related noise exposure had hearing damage in a pattern usually caused by noise. This damage—shown by a distinctive drop in the ability to hear high-pitched sounds—appeared as early as age 20.” But it added that while a few studies have linked noise exposure among young people to the use of portable devices and entertainment venues, more research is needed to determine the relationship between this type of early noise exposure and hearing loss in older age.

Untreated hearing loss is linked with anxiety, depression, loneliness, and stress, the CDC says. In addition to causing hearing loss, chronic noise exposure can worsen heart disease and increase blood pressure, among other adverse health effects.

But don’t forget, noise is the only fully preventable cause of hearing loss.

Please see HHF’s resources on NIHL here, as well as our Summer 2015 cover story about NIHL. Taking care of your hearing should always be part of your overall health. If you suspect a hearing loss, get your hearing checked, and if you do have a hearing loss, get it treated. Avoid noisy areas, and wear protective earplugs or stronger when you need them in noisy environments. Download the CDC’s fact sheet here.

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

 
 
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Want to Be Happier in 2017? Try a Hearing Test.

By the Better Hearing Institute

When you’re making your list of New Year’s resolutions and to-dos for 2017, be sure to put this one near the top: a hearing test.

That’s right. Research shows that when people address hearing loss it improves their quality of life in many ways.

And it’s no wonder. Ignoring a hearing loss and leaving it unaddressed can be exhausting, lead to isolation, and has been tied to an assortment of health conditions, including depression, diminished cognitive function, and an increased risk of falling.

But when people get a hearing test and use professionally fitted and individually programmed hearing aids—when recommended by a hearing care professional—most say they’re happy with the improvements they see in multiple areas of their lives.

Here are just a few potential perks of treating hearing loss that may surprise you:

  1. Your spirits may brighten. People with hearing loss who use hearing aids are less likely to feel down, depressed or hopeless, BHI research shows.

  2. Your relationships may benefit. Most people with hearing loss who use hearing aids say it has a positive effect on their relationships, according to a BHI survey. Research also finds that they’re more likely to have a strong social network.

  3. You may start to see life’s sunny side a little more. People with hearing loss who use hearing aids are more likely to be optimistic, feel engaged in life, and even get more pleasure in doing things, BHI research finds.

  4. Taking the reins on life might become easier. BHI research shows that people with hearing loss who use hearing aids are more likely to tackle problems actively. Not a bad New Year’s resolution in and of itself.

  5. It may lighten your cognitive load. Experts say that effortful listening due to unaddressed hearing loss is associated with increased stress and poorer performance on memory tests. If you don’t have to put so much effort into listening due to untreated hearing loss, more cognitive resources may be available for other things—like remembering what was said, or enjoying the conversation with friends.

So, go ahead. Make a hearing test one of the New Year’s resolutions you keep in 2017. 

So do it for your health. Do it for your happiness. Get a hearing test.

To take a free, quick, and confidential online hearing check to help determine if you need a comprehensive hearing test by a hearing health care professional, visit www.BetterHearing.org

The content for this blog post originated in a press release issued by The Better Hearing Institute.

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Greatness Always Has a Price

By Morgan Leppla and Laura Friedman

Signed in 1990, the Americans with Disabilities Act (ADA) is the most contemporary federal legislation related to disabilities, outlining important workers’ rights and their employers’ obligations to provide reasonable accommodations. However, it does raise questions in regards to union contracts under the National Labor Relations Act (NLRA), which was passed in 1935 and protects workers’ rights to unionize, collectively bargain, and take action (e.g. strikes). Thus, portions of the NLRA and ADA conflict with each other, putting strain on union workers who need reasonable accommodations.

The ADA outlaws discrimination against qualified individuals with disabilities, stating that individuals must negotiate with employers for “reasonable accommodations.” On the other hand, the NLRA prohibits union members from negotiating individually. Once the ADA was passed in 1990, it outlawed any part of previously entered collective bargaining contracts that included discriminatory clauses. Additionally, an employer cannot use a collective bargaining agreement as a means to engage in discriminatory practices that are otherwise prohibited by the ADA.

The challenge for employers is balancing their dual obligations to comply with established collective bargaining arrangements while accommodating individual workplace needs.

Many union contacts contain seniority clauses, providing benefits based on how long union employees have been in their position. For example, an employee who is at a company for 10 years may choose their hours before the newest hire. However, if the newest hire has a disability, it may be necessary for them to pick their hours before the more senior worker as a reasonable accommodation. This violates the union contract and NLRA for two reasons: 1) it can be considered direct dealing with an employee, and 2) it overlooks the terms of the contract. Even so, this accommodation does not otherwise pose “undue hardship,” and therefore should be granted under the ADA.

NOT SO FAST: Firstly, the NLRA does not contain language that protects people with disabilities. Secondly, the ADA was meant to expand upon, not replace, the Rehabilitation Act of 1973, which prohibits discrimination against people with disabilities in federal hiring practices and requires affirmative action in hiring for federal agencies, programs that receive federal funding, federal contractors, and subcontractors. However, the ADA does not have an affirmative action requirement, so employers are no longer obligated to give applicants with disabilities preferential treatment throughout the recruitment or hiring process. Furthermore, ignoring the seniority clauses in collective bargaining agreements would be using affirmative action in the hiring of persons with disabilities, and therefore illegal, adding the web of confusion as to which legislation must employers comply with.

Other issues are related to privacy of medical records. In one instance, a union needed workers’ medical histories in order to meaningfully negotiate their contract, which is permitted by the NLRA but prohibited by the ADA. Due to lack of evidence, guidance, and clarity, the court had the parties settle. While in this particular instance the issue was put to bed, the inability to make a decision failed to set a precedent which could address future disputes.

This amounts to a murky legal landscape. While some of the language has been interpreted by courts, there is a lot employers and individuals need to navigate on their own. Such uncertainty and lack of clarity further hurts the disabled individual because they have to take extra strides to ensure that they receive reasonable accommodations and are not subjected to discrimination based on disability by either the terms of a collective bargaining agreement or the actual employer.

Have a personal experience with discrimination in the workplace or with negotiating reasonable accommodations with an employer? 

Please share it with HHF by emailing info@hhf.org today!

FOOTNOTES:

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Labor Day: A Reflection of Disability in America's Workplace

By Morgan Leppla

Did you know that the first Labor Day in the U.S. was celebrated on September 5, 1892, to commemorate the achievements of the labor movement? More than a century later, we still celebrate our workforce for their contributions and successes. Mandatory safety regulations in the workplace, anti-discrimination policies, and establishing minimum wage are some of the noteworthy milestones accomplished.

Labor Day exudes an inclusive spirit. 

But what about individuals who have a disability?

The Americans with Disabilities Act of 1990 (ADA) mandates that employers must make reasonable accommodations for qualified candidates with disabilities in the workplace. However, many people do not speak up or are ashamed to disclose their disability and needs to their employer, including those with hearing loss.

The employment rate for people who are deaf or hard of hearing in the U.S. is 50 percent, compared with 70 percent among workers who do not have disabilities. There is also a stark disparity between annual income for those who have a substantial hearing loss or are deaf, compared with their typical hearing peers: $38,000 per year vs. $50,000 annually in 2011.

A hearing loss may affect one’s ability to remain communicative and productive in the workplace, as the majority of today’s jobs require some form of verbal correspondence. Whether that is listening to instructions on a construction site, providing medical expertise, or receiving feedback from a supervisor, the words people say tend to be important. Gaps in understanding lead to gaps in accuracy, productivity, and performance.

This is not just an individual worker’s problem either. When people stop working at optimal capacity, bottom lines shrink. And considering that 67 to 86 percent of the 48 million Americans who have hearing loss do not have hearing aids, more dollars than you’d expect could be lost.

Workers’ general wellness includes knowing about, managing, and treating hearing loss, as well as feeling comfortable asking for reasonable accommodations without fear of discrimination. Eradicating the stigma surrounding hearing loss is key to addressing it as an epidemic medically, economically, and socially—and we at HHF are working hard to eliminate that stigma through building education and awareness.

Labor Day is about honoring the workforce. Please join Hearing Health Foundation in celebrating the progress made for American workers, as well as acknowledging the obligation to improve the livelihood, both in and out of the workplace, of our fellow citizens. 

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Enjoy Summer Concert Season Right

By the Better Hearing Institute

With at least another month-and-a-half left of summer concert season, we thought it would be a good time to remind music lovers to pack the earplugs. It’s an easy and smart way to make sure you can enjoy those tunes for years to come.

Bringing earplugs to that next concert is more than a good idea, it should be a must, says the Better Hearing Institute (BHI). Millennials and teens especially should think twice about music volume because data show that hearing loss is on the rise in these age groups, which means they’re permanently losing some of their hearing at younger ages.

But take heart. Earplugs really can help. One study, carried out in conjunction with an outdoor music festival in Amsterdam last fall, found that festival-goers who wore earplugs were roughly five times less likely to have some temporary hearing loss than those who didn’t wear them. The earplug-users also were less likely to suffer from tinnitus afterwards.

Any sounds at or above 85 dBA for a prolonged period of time can be unsafe. The sounds at that Dutch music festival were at 100 decibels, pretty consistently, for 4-and-a-half hours. At that sound level, hearing damage can occur in just 15 minutes.

Luckily, earplugs are pretty easy to come by. Disposable earplugs, made of foam or silicone, usually can be found at local pharmacies. They’re practical because you can still hear music and conversation when they’re in your ears. But when they fit snuggly, they’re effective in adequately blocking out dangerously loud sounds.

The impact of noise on our ears

We hear sound when delicate hair cells in our inner ear vibrate, creating nerve signals that the brain understands as sound. But just as we can overload an electrical circuit, we also can overload these vibrating hair cells. Loud noise damages these delicate hair cells, resulting in sensorineural hearing loss and often tinnitus (ringing in the ears). The cells that are the first to be damaged or die are those that vibrate most quickly—those that allow us to hear higher-frequency sounds clearly.

Warning signs of too much noise

If you have to shout over the noise to be heard by someone within arm’s length, the noise is probably in the dangerous range. Here are the warning signs:

  • You have pain in your ears after leaving a noisy area.

  • You hear ringing or buzzing (tinnitus) in your ears immediately after exposure to noise.

  • You suddenly have difficulty understanding speech after exposure to noise; you can hear people talking but can’t understand them.

Repeated exposure to loud noise, over an extended period of time, presents serious risks to hearing health.

The content for this blog post originated in a press release issued by The Better Hearing Institute on July 19, 2016.

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Summer Is a Time for Play (and Protection)

By Morgan Leppla

“The best offense is one that does not trigger any defense,” says Daniel Gilbert, Ph.D., a psychology professor at Harvard University.

Gilbert says humans are not hardwired to think long term. When people don’t see a threat as immediate, they are not inclined to take action to mitigate it. This psychological phenomenon is why it’s easy to forego protective measures that’ll make a difference in the long run, especially during one of the most fun-filled times of the year: SUMMER!

With its blaring tunes and crackling fireworks, it makes sense that summer excitement distracts us from remembering the permanent effect of noise on our ears. Loud sounds are more insidious than one might expect. This is in spite of the fact that noise-induced hearing loss (NIHL) can happen at any age, to any race, gender, etc. Hearing loss from all causes is a growing epidemic, affecting nearly 50 million Americans.

Sound volume, length of time listening, and repeated exposure to loudness all can lead to NIHL. One extremely loud sound can cause it, but so can exposure to softer (but still dangerous) sounds over an extended period. To put that into tangible terms, a single loud sound may be a shotgun going off right next to you, while sounds that may damage hearing more slowly are repeated exposure to heavy city traffic, music listened to at a high volume using earbuds, or even regular use of a hairdryer!

 

So, with all of these potential threats to hearing, what is there to do?

Here is the trinity of protection: WALK away from loud sounds, BLOCK loud sounds with ear protection, and TURN the volume down (when you can control it). These simple actions can have a major impact on your long-term hearing health.

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Walk, Block, and Turn!

By Maggie Niu

April 27 is International Noise Awareness Day (INAD), a day dedicated to encouraging people to “do something about bothersome noise where they work, live, and play.”

Every day in our environment we experience sound, whether it’s pleasant, like music, or bothersome, like sirens. Unpleasant or unwanted noisy environments can be dreadful; not only can noise increase our stress level and inhibit us from carrying out daily tasks, but also in the long run overexposure to noise can damage our hearing. This is known as noise-induced hearing loss (NIHL). All too often, we become immune to the constant hum of traffic (about 85 decibels, or dB) and noisy subway stations (95 dB). The Safe and Sound safe listening levels chart, on the left, details the effects of various decibel levels on our ears.

There are two causes of NIHL. One is impulse noise, a one-time exposure to a loud sound such as an explosion. This can cause temporary and/or permanent hearing loss. The other cause of NIHL is continuous exposure to loud noise. This type of hearing loss happens gradually over time.

NIHL affects our inner-ear hair cells (the cells that help us hear) as well as the auditory or hearing nerve. Not only can this type of hearing loss be permanent, it can also lead to tinnitus. Tinnitus is hearing a constant ringing, buzzing, or roaring without an external sound source. It can be in one or both ears and often occurs with hearing loss.

 

Now the question is: How do we protect ourselves from NIHL? It can be as easy as remembering to Walk, Block, and Turn! Walk away from loud sounds. Block noise by wearing earplugs or other hearing protective devices. Turn the volume down on stereos and personal music devices. If you work in a noisy environment, take proper measures to protect your ears by wearing ear plugs or ear muffs. Being able to hear is important for daily interactions and often taken for granted until it's too late.

To learn more about Hearing Health Foundation's Safe and Sound program, please email development@hhf.org.

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