Researchers at Duke University and Nottingham University in the UK issued a comprehensive report summarizing the “growing, and alarmingly high” burden of hearing loss around the world. The report, written by Blake Wilson, Debara Tucci, Michael Merson and Gerard O”Donahue, was published in The Lancet in July 2017.
The Lancet article reviewed the most recent Global Burden of Disease (GBD) data, collected in 2015. This data indicated that hearing loss has moved from the 11th leading cause of years lived with disability (YLD)* in 2010 to the 4th leading cause of YLD in 2015. The GBD data also indicated the prevalence of disabling hearing loss is far greater today than 30 years ago. Specifically, global prevalence of hearing loss for both sexes combined increased from 14.33% in 1990 to 18.06% in 2015. Moreover, the estimated prevalence for disabling hearing loss (>35 dB HL losses) increased from 5.73% in 1990 to 6.42% in 2015. Among the reasons for the increase in prevalence is a growing aging population around the globe; a topic of a recent special section of the Economist.
The July 2017 Lancet report summarized the enormous economic and personal consequences of hearing loss around the world, and emphasized that more than 80% of individuals around the globe with hearing loss reside in low and middle income countries. The authors laid out a multiprong approach to reducing the global burden of hearing loss. Like the now familiar PCAST and NASEM reports, included in their recommendations were ideas on how to lower costs and improve bottom line such as using automated hearing screenings, public awareness campaigns and the provision of centers of excellence for complex cases.
Overall, this report in The Lancet serves as a good example of how hearing loss – and its consequences – is a public health challenge with several stakeholders beyond ENT and Audiology. Health care professionals, third party payers, medical and consumer electronic device makers and communities are among the key players in reducing the overall global burden of hearing loss.
Given the rapidly aging population and the disabling nature of untreated hearing loss, ENT/Audiology practices are encouraged to conduct some type of routine screening for hearing loss. The use of a routine health screener, which can be customized to your practice, is a straightforward way to identify risk factors that may warrant a comprehensive audiologic assessment. Practices may conduct a health and hearing screening using a tablet PC or paper and pencil.
Additionally, the GBD data in The Lancet report also serves as a reminder that the provision of non-hearing aid amplifiers is another potential way to reduce the overall burden of disease caused by hearing loss. And, if over-the-counter hearing aids are to become a reality within the next two to three years, the way in which care is delivered by audiologists is likely to change in a couple of ways:
1) A growing number of professional services could be delivered as stand-alone, unbundled options. 2) An emphasis could be placed on comprehensive counseling and support services, such as the provision of hearing loss self-management skills. Audiologists would be wise to strengthen these types of counseling skills and deliver them in an unbundled format, as public health experts and other key advocacy groups continue to push for better access and affordability for underserved populations.
*Per the World Health Organization, years lived with disability (YLDs) are a measurement of the burden of disease. YLDs are calculated by multiplying the prevalence of a disorder by the short- or long-term loss of health associated with that disability. Neuropsychiatric disorders (mental and behavioral disorders) are the leading cause of global YLDs, followed by musculoskeletal disorders and other non-communicable diseases. When YLDs are added to the number of years of life lost for a certain disease or disorder, the burden of disability associated with a disease or disorder can be reported in units called disability-adjusted life years (DALYs).