Skip to main content
Top
Published in: Journal of Community Health 4/2019

01-08-2019 | Care | Original Paper

Rural Adult Perspectives on Impact of Hearing Loss and Barriers to Care

Authors: Whitney Powell, Julie A. Jacobs, Wayne Noble, Matthew L. Bush, Claire Snell-Rood

Published in: Journal of Community Health | Issue 4/2019

Login to get access

Abstract

Adult hearing loss has a significant impact on communication and quality of life. In spite of effective methods of diagnosis and treatment, many rural adults face significant barriers and delays in accessing care. The purpose of this study is to characterize the impact of hearing loss and the barriers for hearing healthcare in rural adults. Using stratified purposeful sampling, the study design involved semi-structured phone interviews with adults in the Appalachian region of Kentucky between 2016 and 2017 to describe perceived susceptibility to hearing loss; knowledge of hearing loss; cues leading to help-seeking; barriers limited access to care; benefits of seeking help; and self-rated confidence in seeking treatment. Thematic qualitative analysis was performed to identify recurring content themes. Forty adults participated in the study. Participants reported susceptibility to noise induced hearing loss with infrequent hearing protection use. Participants described concern with hearing loss-related communication barriers that could affect compliance with medical care, employment performance, personal safety, and relationship communication. Rural adult expressed willingness to seek hearing healthcare but reported a lack of providers in rural areas. The cost and the lack of insurance coverage for hearing aids were the most clearly articulated obstacles influencing access to care. Hearing loss has a significant impact on adults in rural areas. A lack of providers and the overwhelming cost of treatment are barriers to care. Further research is needed to identify novel methods to support rural adults seeking affordable hearing healthcare.
Literature
2.
go back to reference Chien, W., & Lin, F. R. (2012). Prevalence of hearing aid use among older adults in the United States. Archives of Internal Medicine, 172(3), 292–293.CrossRefPubMedPubMedCentral Chien, W., & Lin, F. R. (2012). Prevalence of hearing aid use among older adults in the United States. Archives of Internal Medicine, 172(3), 292–293.CrossRefPubMedPubMedCentral
3.
go back to reference Ciletti, L., & Flamme, G. A. (2008). Prevalence of hearing impairment by gender and audiometric configuration: results from the National Health and Nutrition Examination Survey (1999–2004) and the Keokuk County Rural Health Study (1994–1998). Journal of the American Academy of Audiology, 19(9), 672–685.CrossRefPubMed Ciletti, L., & Flamme, G. A. (2008). Prevalence of hearing impairment by gender and audiometric configuration: results from the National Health and Nutrition Examination Survey (1999–2004) and the Keokuk County Rural Health Study (1994–1998). Journal of the American Academy of Audiology, 19(9), 672–685.CrossRefPubMed
5.
go back to reference Huddle, M. G., Goman, A. M., Kernizan, F. C., Foley, D. M., Price, C., Frick, K. D., et al. (2017). The economic impact of adult hearing loss: a systematic review. JAMA Otolaryngology—Head & Neck Surgery, 143(10), 1040–1048.CrossRef Huddle, M. G., Goman, A. M., Kernizan, F. C., Foley, D. M., Price, C., Frick, K. D., et al. (2017). The economic impact of adult hearing loss: a systematic review. JAMA Otolaryngology—Head & Neck Surgery, 143(10), 1040–1048.CrossRef
6.
go back to reference Kotby, M. N., Tawfik, S., Aziz, A., & Taha, H. (2008). Public health impact of hearing impairment and disability. Folia Phoniatrica et Logopedica, 60, 58–63.CrossRef Kotby, M. N., Tawfik, S., Aziz, A., & Taha, H. (2008). Public health impact of hearing impairment and disability. Folia Phoniatrica et Logopedica, 60, 58–63.CrossRef
7.
go back to reference Lucas, L., Katiri, R., & Kitterick, P. T. (2018). The psychological and social consequences of single-sided deafness in adulthood. International J of Audiology., 57(1), 21–30.CrossRef Lucas, L., Katiri, R., & Kitterick, P. T. (2018). The psychological and social consequences of single-sided deafness in adulthood. International J of Audiology., 57(1), 21–30.CrossRef
8.
go back to reference Mohr, P. E., Feldman, J. J., Dunbar, J. L., McConkey-Robbins, A., Niparko, J. K., Rittenhouse, R. K., et al. (2000). The societal costs of severe to profound hearing loss in the United States. International Journal of Technology Assessment in Health Care, 16, 1120–1135.CrossRefPubMed Mohr, P. E., Feldman, J. J., Dunbar, J. L., McConkey-Robbins, A., Niparko, J. K., Rittenhouse, R. K., et al. (2000). The societal costs of severe to profound hearing loss in the United States. International Journal of Technology Assessment in Health Care, 16, 1120–1135.CrossRefPubMed
9.
go back to reference Murlow, C. D., Aguilar, C., Endicott, J. E., Tuley, M. R., Velez, R., Charlip, W. S., et al. (1990). Quality-of-life changes and hearing impairment: a randomized trial. Annals of Internal Medicine, 113(3), 188–194.CrossRef Murlow, C. D., Aguilar, C., Endicott, J. E., Tuley, M. R., Velez, R., Charlip, W. S., et al. (1990). Quality-of-life changes and hearing impairment: a randomized trial. Annals of Internal Medicine, 113(3), 188–194.CrossRef
10.
go back to reference Chan, S., Hixon, B., Adkins, M., Shinn, J., & Bush, M. (2017). Rurality and determinants of hearing healthcare in adult hearing aid recipients. The Laryngoscope., 127(10), 2362–2367.CrossRefPubMedPubMedCentral Chan, S., Hixon, B., Adkins, M., Shinn, J., & Bush, M. (2017). Rurality and determinants of hearing healthcare in adult hearing aid recipients. The Laryngoscope., 127(10), 2362–2367.CrossRefPubMedPubMedCentral
11.
go back to reference Beckett, W. S., Chamberlain, D., Hallman, E., May, J., Hwang, S. A., Gomez, M., et al. (2000). Hearing conservation for farmers: Source apportionment of occupational and environmental factors contributing to hearing loss. Journal of Occupational and Environmental Medicine, 42(8), 806–813.CrossRefPubMed Beckett, W. S., Chamberlain, D., Hallman, E., May, J., Hwang, S. A., Gomez, M., et al. (2000). Hearing conservation for farmers: Source apportionment of occupational and environmental factors contributing to hearing loss. Journal of Occupational and Environmental Medicine, 42(8), 806–813.CrossRefPubMed
12.
go back to reference Merchant, J. A., Stromquist, A. M., Kelly, K. M., Zwerling, C., Reynolds, S. J., & Burmeister, L. F. (2002). Chronic disease and injury in an agricultural county: The Keokuk County Rural Health Cohort Study. The Journal of Rural Health, 18(4), 521–535.CrossRefPubMed Merchant, J. A., Stromquist, A. M., Kelly, K. M., Zwerling, C., Reynolds, S. J., & Burmeister, L. F. (2002). Chronic disease and injury in an agricultural county: The Keokuk County Rural Health Cohort Study. The Journal of Rural Health, 18(4), 521–535.CrossRefPubMed
13.
go back to reference Agrawal, Y., Platz, E. A., & Niparko, J. K. (2008). Prevalence of hearing loss and differences by demographic characteristics among US adults: Data from the National Health and Nutrition Examination Survey, 1999–2004. Archives of Internal Medicine, 168(14), 1522–1530.CrossRefPubMed Agrawal, Y., Platz, E. A., & Niparko, J. K. (2008). Prevalence of hearing loss and differences by demographic characteristics among US adults: Data from the National Health and Nutrition Examination Survey, 1999–2004. Archives of Internal Medicine, 168(14), 1522–1530.CrossRefPubMed
14.
go back to reference Arcury, T. A., Preisser, J. S., Gesler, W. M., & Powers, J. M. (2005). Access to transportation and health care utilization in a rural region. The Journal of Rural Health, 21(1), 31–38.CrossRefPubMed Arcury, T. A., Preisser, J. S., Gesler, W. M., & Powers, J. M. (2005). Access to transportation and health care utilization in a rural region. The Journal of Rural Health, 21(1), 31–38.CrossRefPubMed
15.
go back to reference Blazer, D. G., Landerman, L. R., Fillenbaum, G., & Horner, R. (1995). Health services access and use among older adults in North Carolina: Urban vs rural residents. American Journal of Public Health, 85(10), 1384–1390.CrossRefPubMedPubMedCentral Blazer, D. G., Landerman, L. R., Fillenbaum, G., & Horner, R. (1995). Health services access and use among older adults in North Carolina: Urban vs rural residents. American Journal of Public Health, 85(10), 1384–1390.CrossRefPubMedPubMedCentral
16.
go back to reference Brems, C., Johnson, M. E., Warner, T. D., & Roberts, L. W. (2006). Barriers to healthcare as reported by rural and urban interprofessional providers. Journal of Interprofessional Care, 20(2), 105–118.CrossRefPubMed Brems, C., Johnson, M. E., Warner, T. D., & Roberts, L. W. (2006). Barriers to healthcare as reported by rural and urban interprofessional providers. Journal of Interprofessional Care, 20(2), 105–118.CrossRefPubMed
17.
go back to reference Goins, R. T., Williams, K. A., Carter, M. W., Spencer, M., & Solovieva, T. (2005). Perceived barriers to health care access among rural older adults: A qualitative study. J Rural Health., 21(3), 206–213.CrossRefPubMed Goins, R. T., Williams, K. A., Carter, M. W., Spencer, M., & Solovieva, T. (2005). Perceived barriers to health care access among rural older adults: A qualitative study. J Rural Health., 21(3), 206–213.CrossRefPubMed
18.
go back to reference Hixon, B., Chan, S., Adkins, M., Shinn, J. B., & Bush, M. L. (2016). Timing and impact of hearing healthcare in adult cochlear implant recipients: A rural–urban comparison. Otology and Neurotology, 37(9), 1320–1324.CrossRefPubMed Hixon, B., Chan, S., Adkins, M., Shinn, J. B., & Bush, M. L. (2016). Timing and impact of hearing healthcare in adult cochlear implant recipients: A rural–urban comparison. Otology and Neurotology, 37(9), 1320–1324.CrossRefPubMed
20.
go back to reference Snell-Rood, C., Merkel, R., & Schoenberg, N. (2018). Negotiating the interpretation of depression shared among kin. Medical Anthropology, 37(7), 538–552.CrossRefPubMed Snell-Rood, C., Merkel, R., & Schoenberg, N. (2018). Negotiating the interpretation of depression shared among kin. Medical Anthropology, 37(7), 538–552.CrossRefPubMed
21.
go back to reference Drew, E. M., & Schoenberg, N. E. (2011). Deconstructing fatalism: Ethnographic perspectives on women’s decision making about cancer prevention and treatment. Medical Anthropology Quarterly, 25(2), 164–182.CrossRefPubMedPubMedCentral Drew, E. M., & Schoenberg, N. E. (2011). Deconstructing fatalism: Ethnographic perspectives on women’s decision making about cancer prevention and treatment. Medical Anthropology Quarterly, 25(2), 164–182.CrossRefPubMedPubMedCentral
22.
go back to reference Snell-Rood, C., Hauenstein, E., Leukefeld, C., Marcum, A., & Schoenberg, N. (2017). Mental health treatment-seeking patterns and preferences of appalachian women with depression. American Journal of Orthopsychiatry, 87(3), 233–241.CrossRefPubMed Snell-Rood, C., Hauenstein, E., Leukefeld, C., Marcum, A., & Schoenberg, N. (2017). Mental health treatment-seeking patterns and preferences of appalachian women with depression. American Journal of Orthopsychiatry, 87(3), 233–241.CrossRefPubMed
23.
go back to reference Schoenberg, N. E., Leach, C., & Edwards, W. (2009). “It’s a toss up between my hearing, my heart, and my hip”: Prioritizing and accommodating multiple morbidities by vulnerable older adults. Journal of Health Care for the Poor and Underserved, 20(1), 134–151.CrossRefPubMedPubMedCentral Schoenberg, N. E., Leach, C., & Edwards, W. (2009). “It’s a toss up between my hearing, my heart, and my hip”: Prioritizing and accommodating multiple morbidities by vulnerable older adults. Journal of Health Care for the Poor and Underserved, 20(1), 134–151.CrossRefPubMedPubMedCentral
24.
go back to reference Keppler, H., Ingeborg, D., Sofie, D., & Bart, V. (2015). The effects of a hearing education program on recreational noise exposure, attitudes and beliefs toward noise, hearing loss, and hearing protector devices in young adults. Noise & Health., 17(78), 253–262.CrossRef Keppler, H., Ingeborg, D., Sofie, D., & Bart, V. (2015). The effects of a hearing education program on recreational noise exposure, attitudes and beliefs toward noise, hearing loss, and hearing protector devices in young adults. Noise & Health., 17(78), 253–262.CrossRef
25.
go back to reference Shell, R., et al. (2004). Barriers to cancer screening by rural Appalachian primary care providers. The Journal of Rural Health, 20, 368–373.CrossRefPubMed Shell, R., et al. (2004). Barriers to cancer screening by rural Appalachian primary care providers. The Journal of Rural Health, 20, 368–373.CrossRefPubMed
26.
go back to reference Elpers, J., Lester, C., Shinn, J. B., & Bush, M. L. (2016). Rural family perspectives and experiences with early infant hearing detection and intervention: A qualitative study. Journal of Community Health, 41(2), 226–233.CrossRefPubMedPubMedCentral Elpers, J., Lester, C., Shinn, J. B., & Bush, M. L. (2016). Rural family perspectives and experiences with early infant hearing detection and intervention: A qualitative study. Journal of Community Health, 41(2), 226–233.CrossRefPubMedPubMedCentral
27.
go back to reference Arnold, M. L., Hyer, K., & Chisolm, T. (2017). Medicaid hearing aid coverage for older adult beneficiaries: A state-by-state comparison. Health Affairs (Millwood)., 36(8), 1476–1484.CrossRefPubMed Arnold, M. L., Hyer, K., & Chisolm, T. (2017). Medicaid hearing aid coverage for older adult beneficiaries: A state-by-state comparison. Health Affairs (Millwood)., 36(8), 1476–1484.CrossRefPubMed
Metadata
Title
Rural Adult Perspectives on Impact of Hearing Loss and Barriers to Care
Authors
Whitney Powell
Julie A. Jacobs
Wayne Noble
Matthew L. Bush
Claire Snell-Rood
Publication date
01-08-2019
Publisher
Springer US
Keyword
Care
Published in
Journal of Community Health / Issue 4/2019
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI
https://doi.org/10.1007/s10900-019-00656-3

Other articles of this Issue 4/2019

Journal of Community Health 4/2019 Go to the issue