Untreated Hearing Loss Puts Overall Health at Risk

Hearing Health Foundation (HHF) CEO Nadine Dehgan’s “Treating Hearing Health for Better Overall Health” was published online to My Prime Time News following its original print appearance in The American Legion’s December 2017 issue.

The article details how the state of the inner ear impacts other critical functions, like the heart and the brain. Cited are the various conditions that can arise as a result of untreated hearing loss, including cardiovascular disease, dementia, diabetes,  depression, and falls. When the auditory system is functioning well, however, the risk for these ailments declines.

Additionally, hearing loss is also linked to other medical conditions and drugs. People with anemia are twice as likely to have hearing loss. According to Peter Steyger, Ph.D., a scientific adviser to HHF. Further, certain cancer-fighting chemotherapy drugs, such as cisplatin, may permanently harm hearing.

While the relationship between hearing health and overall health is always significant, the publicity of “Treating Hearing Health for Better Overall Health” is an especially timely and helpful follow-up to ERG recipient Harrison Lin, M.D.’s new findings concerning the gaps between self-reported hearing loss and patients evaluation and treatments for hearing loss, which appeared in this month’s issue of JAMA Otolaryngology—Head & Neck Surgery.

Individuals who believe they may have a hearing loss are encouraged to consult an audiologist or ENT, and can learn more about the relationship between hearing health and overall health in the full article on My Prime Time News.

Tuning In

By Laura Friedman

As my three-year work anniversary approaches, I’ve been reflecting on my learnings as a team member of Hearing Health Foundation (HHF). There is one that sticks out the most: As someone who has only known her life as being one with hearing loss and wearing hearing aids (I was diagnosed at age 3 ½), I don’t know what I’m missing, compared with my typical hearing peers. I have learned from those who have acquired hearing loss later in life, even as young adults, that they are acutely aware of the difference in their hearing experience even with assisted listening devices. They aren’t enjoying music like they once did, they have increased difficulties hearing conversational speech around the dinner table and at restaurants, and they are missing things in meetings that the “old” them would never miss.

Ok, I lied. There are actually two major learnings. The second is, which is something I’ve experienced within my own family, is the prevalence of hearing loss denial and the resistance to treating one’s hearing loss. For those who do acknowledge their hearing loss, many do not wear their hearing devices, further isolating them from a world they were previously a part of.

As a young child when I visited my grandfather, who was notorious for not wearing his hearing aids, I told him, “If I have to wear mine, you have to wear yours!” He would give me his signature smirk and appease his granddaughter. But I knew once I left, back in the drawers those hearing aids went.

Denying the existence of an ailment or resisting treatment is not unique to hearing loss; this is true for many diagnosed with other serious and life-changing conditions. However, when it comes to hearing loss, almost one-third of an estimated 40 million U.S. adults with hearing difficulties haven’t even taken the first step to see a specialist for help. What’s even more troubling is today it is estimated that 360 million people worldwide have hearing loss, with 1.1 billion people at risk for acquiring it, according to the World Health Organization.

In the U.S. nearly 25 percent of those ages 65 to 74 and half of those older than 75 have a disabling hearing loss. An even more astounding fact is that over 70% of adults in the U.S. who have hearing loss and who would benefit from a hearing aid don’t have one.

Studies show that untreated mild to moderate hearing loss is linked to increased levels of loneliness and isolation, depression, dementia, and medical conditions like heart disease and diabetes. It can even hurt earning potential and career mobility. Treating hearing loss can significantly offset and decrease the risk of acquiring these consequences. So the question is: If treating hearing loss deters the onset of detrimental health conditions, why aren’t more people taking preventative measures to protect their hearing or taking actionable steps to treat it?

For those in the U.S. there is unfortunately little to no insurance and Medicare coverage for hearing aids, meaning those who need them most are unable afford them. While there’s still a lot left to do, policy is slowly moving in the right direction: In August 2017 the Over-the-Counter Hearing Aid Act was signed into law, paving the way for a new class of hearing aids to enter the marketplace. This will provide greater access to hearing technologies for those with mild-to-moderate hearing loss at a fraction of the price.

I can’t imagine how frustrating it must be to know what you’re missing; it is my wish that nobody has to experience that feeling. This is why I chose to work for an organization dedicated to funding research to develop better technologies, therapies and cures for hearing and balance disorders. Discoveries are the only way to better the listening experience of those with hearing loss and bring more options to the market.

I ask you to do this one thing: Get your hearing tested and encourage your friends and loved ones to do the same. If necessary, treat your hearing loss. Treating hearing loss has been a life-changer for me, as well as millions of others around the world, who choose to tune in, ultimately benefiting our health, work, and life.

Laura Friedman is the Communications and Programs Manager of Hearing Health Foundation. Read her hearing loss story in the Spring 2016 issue of Hearing Health magazine.

I Want You to Know About My Hearing Loss

By Lauren McGrath

Maureen “Marzi” Wilson is an author, illustrator, and self-described introvert. As one who goes about life with the tendency to speak less and listen more, she fittingly calls her latest collection of artwork Introvert Doodles.

Marzi does not have hearing loss. “As someone with typical hearing, I believe that I and others like me have a lot to learn from those with hearing loss. We need to pay attention to their experiences,” Marzi writes.

Marzi Wilson's "I'm Deaf/Hard of Hearing" gives individuals with hearing loss a way to voice their experience.

“I’m Deaf/Hard of Hearing” is Marzi’s latest relatable masterpiece about hearing loss in her “I Want You to Know” series. “I Want You to Know” is Marzi’s honest attempt to educate her viewers about hearing loss and other conditions that can be misunderstood or stigmatized. She knows that even the most well-meaning people have misconceptions about what does not affect them firsthand.

Since Marzi does not fully know what it is like to be hard of hearing, her work represents the feelings and experiences of real people with whom she’s connected online. To gather inspiration for her “I Want You to Know” pieces, Marzi engages with individuals who are personally affected. They describe the biases that interfere with their lives and offer practical solutions to their typical counterparts. This process provides “an opportunity for them to voice their experiences—I just illustrate them,” Marzi says, humbly.

In addition to spotlighting hearing loss in “I Want You to Know,” Marzi has previously created doodles on autism, grief, and obsessive-compulsive disorder and plans to craft future illustrations about chronic illness, dyslexia, and miscarriage.

She understands her introverted nature as a creative advantage. In her words, shyness goes hand in hand with being “perceptive, creative, and thoughtful”—the very characteristics needed to compassionately capture important pieces of human experience.

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

Talk to Your Loved Ones About Hearing Loss, HHF Urges in Renew Magazine

Hearing Health Foundation (HHF) Board of Directors member Anil Lalwani, M.D. and Communications and Programs Manager Laura Friedman recently shared their expertise about untreated hearing loss and how to encourage a loved one—with compassion—to get help.

The story, "Heart of Hearing," is found on page 26 in the latest issue of Renew, a publication of United Healthcare and AARP. 

“Regardless of age, type of hearing loss, or cause, if left untreated or undetected, hearing loss can have negative effects on your well-being,” says the Hearing Health Foundation’s Laura Friedman. “Untreated hearing loss can lead to numerous negative social, psychological, cognitive and health effects, and can seriously impact professional and personal life, at times leading to isolation and depression.” 

As the consequences of untreated hearing loss can be devastating, Anil Lalwani urges readers to offer encouragement to their loved ones with untreated hearing loss. 

“Often the individual with hearing loss is unaware of what they cannot hear,” explains Lalwani. Whether you think your loved one is aware of his or her potential hearing loss or not, it’s important to approach the topic lovingly."

Read the full piece in Renew magazine on page 26. 

The Hearing Journey: What Matters to You?

By Laura Friedman

Participants used post-it notes to express their desired improvements to the hearing journey. Photo by Darcy Benson.

Recently, in October 2017, I represented Hearing Health Foundation (HHF) at a seminar that took place in Skodsborg, Denmark, where I and 30 other attendees from around the world were tasked with closely exploring and developing tactical strategies to better the patient experience when receiving audiological care.

The seminar conversations focused on person-centered care, a treatment model that focuses on the whole person, rather than just the ailment or condition experienced by the patient. The peer-reviewed Permanente Journal says that person-centered care is “based on accumulated knowledge of people, which provides the basis for better recognition of health problems and needs over time and facilitates appropriate care for these needs in the context of other needs.” Furthering this sentiment, the World Health Organization identifies empowerment, participation, the central role of the family, and an end to discrimination as the core values of person-centered care.

The two-day symposium was titled, “The Hearing Journey: What Matters to You?” The 31 attendees fell into one or more of the following groups: individuals with hearing loss, representatives from prominent consumer-driven associations for people with hearing loss, audiologists, and hearing healthcare thought leaders. The conference was hosted by the Ida Institute, a Denmark-based nonprofit that aims to better understand human dynamics associated with hearing loss.

The symposium participants pose as a group. Photo by Darcy Benson.

One of the most eye-opening takeaways was recognizing that all those who are part of the care-cycle feel shared sentiments of frustration, poor communication, lack of access, and high costs. Addressing each of these hurdles from a variety of vantage points is key to bettering person-centered care and may not be limited to just audiological care, but rather medical care as whole.  

Exercises and projects resulted in several meaningful insights related to person-focused hearing healthcare. We spoke openly about stigma, barriers to rehabilitation, and the need for creating a “new narrative” for how we speak about hearing loss. Changing how we talk about hearing loss, such as how our current nomenclature addresses it as a loss or deficit, will hopefully play a role in changing social stigmas and taboos experienced by those who are hard of hearing, like myself.

HHF's Laura Friedman presents to the group with Paul Breckell, Chief Executive of Action on Hearing Loss. Photo by Darcy Benson.

All parties stressed the importance of including caregivers and family members in the rehabilitation process, and the need for a multidimensional model of care to address the psychological and emotional aspects of hearing care. This included developing a “human audiogram” to discuss diagnoses and their subsequent treatment options in more friendly terms that empowers the patient, rather than discouraging them. It was also advised that clinicians should be more cognizant that diagnoses are difficult for the patient to come to terms with and remember that the most successful patients want treatment, but that it may take time for them to feel motivated to take that next step. Follow-up appointments, rather than immediate discussion of treatment options, was a suggestion most agreed would serve the patient and clinician well.

I feel honored to had been afforded the opportunity to represent HHF at this important symposium and to meet and learn from fellow leaders in the hearing healthcare space. I look forward to working with Ida and my fellow attendees to develop and employ tangible tools and solutions to better a patient’s hearing journey both in and out the audiologist's office, as well as provided better resources to health care providers.

Laura Friedman is the Communications and Programs Manager of Hearing Health Foundation. Read her hearing loss story in the Spring 2016 issue of Hearing Health magazine.

A Tribute to Our Nation’s Veterans

By Laura Friedman

Each year on Veterans Day, November 11, we proudly honor the men and women who have bravely served our country and fought to protect our freedoms.

Veterans Day is important because it honors our soldiers and it is a time to raise awareness about their experiences on and off the battlefield. Noise-induced hearing loss (NIHL) and tinnitus (ringing in the ears) are the top two health conditions among military veterans, according to the U.S. Department of Veterans Affairs (VA). By the end of fiscal year 2016 over 1 million veterans received disability compensation as a result of hearing loss, and about 1.6 million received compensation for tinnitus.

In addition to being disproportionately affected by hearing loss and tinnitus, our soldiers and veterans are also more susceptible to developing central auditory processing disorders (CAPD). CAPD occurs when one can hear sounds but is unable to understand the words. It is sometimes caused by intense exposure to sudden and loud noises from improvised explosive devices (IEDs), ammunition and engine noise.

"Both post-blast trauma and CAPD are difficult, diffuse disorders where more work is needed, particularly on people working in extreme conditions, acoustic and otherwise, such as veterans." —Edward Bartlett, Ph.D., Associate Professor, Biological Sciences and Biomedical Engineering Purdue University

Blasts can result in temporary hearing loss and put military personnel at risk. However, the word “temporary” should be approached with caution: Repeated short-term hearing loss can damage the sensitive hair cells in the inner ear, leading to permanent hearing loss.

Hearing loss and tinnitus as a result of noise is largely preventable. There’s a misconception that not using hearing protection would inhibit vital communication and mission readiness. With today’s increasingly sophisticated technology, soldiers no longer need to choose between protecting their ears or their lives. Wearing hearing protection such as noise-attenuating helmets, which use ear cups to protect against hazardous sound, or Tactical Communication and Protective Systems, which protect against loud noises while amplifying soft ones, can go a long way to reduce overall exposure, while ensuring vital communications.

Any form of hearing loss can be detrimental to soldiers on duty, as the ability to hear signs of danger and to communicate with fellow soldiers is crucial for mission success and survival. Off-duty, hearing loss and tinnitus can also impact one’s well-being.

Regardless of age, type of hearing loss, or cause, if left untreated or undetected hearing loss can lead to considerable, negative social, psychological, cognitive, and health effects. As a result, it can seriously impact professional and personal life, potentially leading to isolation and depression. Treating hearing loss can also decrease one’s risk of acquiring other serious medical conditions, such as cardiovascular disease, dementia, and diabetes.

Veterans who have acquired hearing loss and tinnitus, either as a result of war or through other causes, can seek treatment at their local Department of Veterans Affairs (VA) medical center. Through partnerships with local community providers, the VA offers comprehensive hearing health services including screening, evaluation, treatment, and/or management of hearing, tinnitus, and balance disorders.

While it may be daunting to take the initial step of having a hearing test, it is important to know there are many different treatment options available. Some forms of hearing loss, such as those that affect the middle ear, are treatable through surgery. Damage to the inner ear and auditory nerve can cause permanent hearing loss; however technologies such as hearing aids, assistive/alerting devices, TV and telephone amplifiers, and cochlear and other auditory implants can optimize residual hearing by amplifying sounds.

As for tinnitus treatments, many patients have seen improvements with counseling and sound therapy, cognitive behavioral therapy (CBT), and the use of white-noise machines. Be sure to discuss the cause of your hearing loss and tinnitus and various treatment options with your audiologist or ear, nose, and throat specialist (ENT).

“On this and every Veterans Day, HHF sincerely thanks our military and our veterans for their brave service and sacrifice. I would also encourage all members, past and present, to have their hearing tested and monitored by a hearing health professional on a regular basis.” —Nadine Dehgan, CEO, Hearing Health Foundation.

Please visit va.gov/directory/guide to find your local VA medical facility. Please also see our Fall 2017 issue of Hearing Health magazine, whose theme is Veterans & Seniors, available at hhf.org/magazine.

Protecting Your Hearing Means Protecting Your Mental Health

By Carol Stoll and Lauren McGrath

October is Protect Your Hearing Month—and, today, October 10, is World Mental Health Day, a time for mental health education, awareness, and advocacy. Hearing loss and tinnitus (ringing in the ears) can increase one’s risk of developing mental illnesses including depression, anxiety, schizophrenia, and dementia, and can trigger episodes of extreme anger and suicidal ideation. Protecting one’s hearing not only prevents or delays hearing loss, but also benefits mental wellness. Understanding the signs of mental illness and having access to mental health resources is critical—and can even be life-saving—to all individuals with hearing loss or tinnitus.

According to an April 2014 study published in JAMA Otolaryngology Head & Neck Surgery, 11.4% of adults with self-reported hearing impairment have moderate to severe depression, significantly higher than the 5.9% prevalence for those with typical hearing. Individuals with hearing loss have reported feeling socially inept in group settings, entering conversations at inappropriate times, talking off-topic, or dominating conversations and coming across as rude simply because talking is easier than listening. When a person cannot hear properly, engaging in conversations is a daily struggle, and can lead to social isolation and depression. Other factors that increase the risk of depression include being female, low-income, a current smoker, binge drinking, having fair or poor health status, trouble seeing, and sleep disorder. However, even controlling for these factors, those with hearing impairment still had significantly higher rates of depression than those without hearing impairment. In people 65 and older, hearing impairment is among the most common chronic conditions associated with depression.

In addition to depression, hearing loss has been linked to schizophrenia. Several studies support the social defeat hypothesis, which proposes that social exclusion and loneliness can predispose people to schizophrenia by increasing sensitization of the dopamine system. In a December 2014 study published in JAMA Psychology, participants with hearing loss reported significantly more feelings of social defeat than healthy controls. Though their psychotic symptoms were similar to the control group, exposing them to a stimulant drug showed that those with hearing loss had significantly higher than normal dopamine sensitivity. Further studies are needed to draw definite conclusions of the causation, but this research is a first step in understanding the relationship between hearing impairment, social defeat, and psychosis.

In older adults, hearing loss is associated with cognitive decline and dementia, according to a February 2013 study published in JAMA Internal Medicine and several other studies conducted at Johns Hopkins University. The scientists concluded that reduced social engagement and a cognitive load focused on coping with hearing loss rather than higher level thinking can lead to poorer cognitive functioning and faster mental decline. Hearing aids could possibly be a simple fix to increase healthy brain function in the older adult population and reduce the risk of dementia.

Exposure to noise often results in tinnitus instead of or in addition to hearing loss, which can also contribute to a range of psychological disorders. Tinnitus affects about 1 in 5 people in the U.S., and causes permanent ringing in the ears. Though research for therapies is ongoing, there is currently no cure. Without therapy, constant ringing in the ears can be debilitating; it can affect job performance, cause insomnia, and provoke fear, anxiety, and anger. This can lead to depression, anxiety, suicidal ideation, and can exasperate post-traumatic stress disorder (PTSD).

Compromised hearing is an invisible disability, often unnoticed or ignored even by those affected. However, hearing loss and tinnitus are widespread and can have serious psychological repercussions. Hearing loss caused by noise exposure is completely preventable by taking simple measures like turning down the volume on your earbuds and using hearing protective devices in loud situations. Regular hearing screenings can also help detect hearing issues early on. Talk to your audiologist about best ways to treat or manage your hearing impairment. Find help for mental illnesses here.

Per the National Institute of Mental Health: "If you are in crisis, and need immediate support or intervention, call, or go the website of the National Suicide Prevention Lifeline (Voice: 1-800-273-8255 or TTY: 1-800-799-4889). Trained crisis workers are available to talk 24 hours a day, 7 days a week. Your confidential and toll-free call goes to the nearest crisis center in the Lifeline national network. These centers provide crisis counseling and mental health referrals. If the situation is potentially life-threatening, call 911 or go to a hospital emergency room.”

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

5 Critical Facts About Hearing Protection

By Laura Friedman

October is National Protect Your Hearing Month. How many of these facts from Hearing Health Foundation (HHF) do you know?

Fact #1: Noise-induced hearing loss (NIHL) is acquired from excessive noise

• ~30 million U.S. workers are exposed to hazardous noise levels on the job

• Nearly 1 in 5 American teenagers are expected to acquire hearing loss largely due to overexposure of loud sounds

• 25% of Americans age 65-74 and nearly 50% of those 75+ have disabling hearing loss

• Approximately two-thirds of service members and veterans have NIHL or tinnitus, or both

• Many veterans also have processing disorders as a result of blast or high noise exposure

Fact #2: NIHL is preventable. The measures needed to prevent NIHL are simple: “Walk, Block, and Turn. Walk away from the sound source, block your ears using ear plugs, and turn down the volume,” advises Nadine Dehgan, HHF’s CEO.

Fact #3: Musicians are 57% more likely to experience tinnitus and are almost four times more likely to develop NIHL than the general public. Sound onstage can reach up to 110 decibels (dB), the equivalent of a jackhammer. Prolonged exposure to loud noise causes hair cells of the inner ear to be damaged, leading to permanent hearing loss.

Fact #4: A portable listening device at maximum volume (105 dB) is louder than heavy city traffic, drills, noisy subway platform and equal to a table saw. Blasting the volume in earbuds hurts hearing. It is estimated that 20% of teenagers, an age group that frequently uses portable listening devices, will suffer from hearing loss from overexposure to noise.

Fact #5: Steps to identify and prevent hearing loss should begin at birth. In 1993, only 5% of newborns were tested for hearing loss at birth. Thanks to HHF’s instrumental role in passing Universal Newborn Hearing Screening legislation, today that number is 97%. Early detection and intervention helps diminish or even eliminate negative impacts of undetected hearing loss on social, academic and emotional development in children with hearing loss.

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

Labor Day and Working with Hearing Loss

By Katelyn Serpe

Since 1894, when Labor Day was named a federal holiday, the United States has celebrated the labor movement and the many contributions that workers have made in improving the lives of Americans across the country. Establishing a minimum wage and child labor laws are just a few of the accomplishments that have been made since the start of the labor movement.

Among these accomplishments are various workplace safety regulations, including recommendations for occupational noise exposure. Yet despite these regulations, the National Institute for Occupational Safety and Health (NIOSH) estimates that 30 million U.S. workers are exposed to noise levels high enough to cause hearing loss. With approximately 150 million Americans in the workforce, nearly 1 in 5 U.S. workers are exposed to noise levels high enough to cause hearing loss.

According to the Centers for Disease Control and Prevention, an estimated 24% of hearing loss in the United States has been a result of workplace exposure, yet people with a hearing loss are often hesitant to disclose their hearing loss in the workplace due to the associated stigmas. Some people with a hearing loss may not seek treatment immediately if they view their hearing loss as an unimportant issue. Yet others may not even be aware they have a hearing loss due to the low number of people who regularly receive hearing screenings.

People with hearing loss are less likely to be in the labor force with nearly half (47%) of people with hearing loss not in the labor force compared with 23% of typical hearing individuals. And the unemployment rate for those with a hearing loss is nearly double that of the typical hearing population.

Having a hearing loss comes with its own challenges but an undisclosed hearing loss in the workplace can increase work-related stress and cause problems in the workplace. Most jobs require some form of verbal communication and an undisclosed hearing loss can decrease efficient verbal communication. This can result in incorrect work due to a lack of comprehension of verbal instructions or a general decrease in productivity. A person with undisclosed hearing loss may, therefore, lose out on promotions and possibly face a loss in annual wages. People with untreated hearing loss can lose as much as $30,000 in annual income and earn approximately 25% less than their typical-hearing peers.

Fortunately, the use of hearing aids has been shown to nearly eliminate the risk of income loss for those with milder hearing loss, and reduce the risk of income loss significantly for those with moderate to severe hearing loss. But while it may seem that the use of hearing aids is a solution for the risk of income loss for people with hearing loss, only 1 in 4 people who could benefit from hearing aids currently owns them.

Employers can help reduce the economic costs of hearing loss by creating environments where people with a hearing loss are unafraid to acknowledge their hearing loss. Making hearing tests part of a company wellness program, making sure hearing aids are covered by company insurance, and providing reasonable accommodations for those with hearing loss are some steps that employers can take to decrease the stigma of having a hearing loss in the workplace.

Through education and raising awareness about the prevalence of hearing loss among Americans, Hearing Health Foundation hopes to erase the stigmas surrounding hearing loss.

We hope you will join Hearing Health Foundation this Labor Day in celebrating the achievements made so far to improve the lives of working Americans while also encouraging further progress to improve American lives both in and out of the workplace.