When we think about social justice and health equity, hearing health is not often part of the conversation. But a closer look at the causes and treatments for hearing health reveals that it should be. Hearing loss is one of the most common chronic health conditions worldwide, affecting over 1.5 billion people globally and nearly 1 in 8 Americans. Yet access to hearing care remains deeply unequal, with disparities rooted in income, geography, race, age, education, and stigma.

Here, we explore why hearing health is a social justice issue, examine the barriers to care, and highlight what can be done to build a more equitable future for people with hearing loss.

The Impact of Hearing Loss

Hearing loss is more than a medical issue. It’s a communication and quality-of-life challenge. Untreated hearing loss is associated with:

• Cognitive decline and dementia

• Depression, anxiety, and social isolation

• Delayed language development in children 

• Lower employment rates and earnings in adults

• Increased overall health care costs

In short, hearing loss impacts nearly every facet of life, and for already marginalized populations, these impacts are compounded.

Hearing Health Disparities: Who Is Affected Most?

Low-Income Individuals and Families

Hearing aids can cost $2,000–$7,000 per pair and are not covered by traditional Medicare or many private insurance plans. Studies show that only 19% of adults with hearing loss in low-income brackets use hearing aids, compared to 38% in higher-income groups.

Rural and Underserved Communities

Access to audiologists and ENT specialists is lower in rural areas. Approximately 60% of U.S. counties lack a practicing audiologist, making access to care difficult. These geographic disparities result in delays in diagnosis and treatment, particularly in children and older adults.

Communities of Color

Black and Hispanic individuals are less likely to be diagnosed with hearing loss and even less likely to receive treatment. Factors include systemic racism, language barriers, insurance gaps, and mistrust in health systems. Black adults, for example, are significantly less likely to wear hearing aids even when severity of hearing loss is equal.

Older Adults

While nearly two-thirds of adults over 70 have hearing loss, only about 30% use hearing aids. Cost, mobility issues, and stigma are major barriers. Untreated hearing loss in older adults is linked to higher rates of cognitive decline, falls, and social withdrawal.

Social Determinants of Hearing Health

Like many health outcomes, hearing health is shaped by the social determinants of health, including income, education, employment, language, and access to health care. These upstream factors influence:

• Awareness: Whether individuals recognize hearing loss and know how to get help.

• Affordability: Whether they can afford hearing aids or follow-up care.

• Accessibility: Whether they have access to audiologists or ENT clinics.

• Advocacy: Whether they’re empowered to seek care or accommodations.

The Role of Policy and Innovation

Over-the-Counter (OTC) Hearing Aids

In 2022, the FDA approved OTC hearing aids for adults with mild to moderate hearing loss. These devices are significantly more affordable (often $300–$1,000 per pair) and available without a prescription, improving access for millions.

Medicare Expansion Efforts

As of now, traditional Medicare does not cover hearing aids, though many advocates are pushing for expanded coverage. The Medicare Hearing Aid Coverage Act and similar proposals aim to include hearing care as a standard benefit.

School-Based Screenings

Early identification is critical for children, especially those from low-income backgrounds. Ensuring universal hearing screenings in schools and funding early intervention services helps reduce lifelong disparities in language and learning.

Building a More Equitable Hearing Health System

To make hearing care accessible and equitable, we need system-level solutions:

• Insurance Reform: Require coverage of hearing aids, cochlear implants, and auditory rehab in public and private plans.

• Workforce Investment: Expand training and incentives for audiologists and hearing professionals in underserved areas.

• Stigma Reduction: Normalize the use of hearing aids through education campaigns.

• Culturally Competent Care: Increase diversity in audiology and ensure care is inclusive and language-accessible.

• Public Awareness: Launch health literacy initiatives around hearing loss, especially in underserved communities.

Healthy hearing should not be a luxury. Everyone deserves the ability to communicate, connect, and participate fully in society, regardless of income, race, or geography.

By recognizing hearing loss as a health equity issue, we can push for systemic change that empowers all individuals to access the hearing care they need.

Want to Get Involved?

• Support legislation for hearing aid coverage.

• Donate to nonprofit hearing clinics serving low-income and uninsured patients.

• Encourage local schools and community centers to offer hearing screenings.

• Talk about hearing loss to reduce stigma and normalize seeking help.

Let’s build a future where everyone has the right to hear and be heard.