Hearing Loss and Sociodemographic Barriers to Health Care Access Using the All of Us Research Program.

ABSTRACT

OBJECTIVE: To explore how gender and low-income status independently influence general health care access in patients with hearing loss. STUDY DESIGN: Cross-sectional study. SETTING: National database. METHODS: Patients with a diagnosis of sensorineural hearing loss from the National Institutes of Health All of Us database were included. Data entered from May 2018 to November 2022 was analyzed. Patient demographics such as age, gender, educational level, and insurance status were assessed. Multivariate logistic regressions were performed for statistical evaluation. RESULTS: A subset of 8875 patients (48.3% male, mean age 69) were evaluated. After multivariate analysis, female participants were more likely than male participants to report difficulty affording prescribed medications (odds ratio [OR] 1.7, p < .0005) and specialists (OR 1.4, p < 0.005). Female patients were also more likely to delay care due to elder care responsibilities (OR 2.6, p < .0005), employment obligations (OR 1.7, p < .0005), and feelings of apprehension in seeing a provider (OR 1.7, p < .0005). Finally, female participants reported feeling less likely to be involved in their own medical care compared to males (OR 1.2, p < .005). Low-income (<$25,000) participants reported less likely to feel respected (OR 3.2, p < .0005) and delivered understandable health information (OR 2.3, p < .0005) by providers compared to participants of higher income. CONCLUSION: This work suggests that patients with hearing loss, female gender, and lower socioeconomic status independently introduce barriers to health care access and utilization. These factors should be considered in efforts to promote equity in the care of patients with hearing loss.