Gender differences in self-reported hearing loss and hearing aid use: a cross-national comparison.

Background: Objective measurements estimated that 1.57 billion people globally had hearing loss in 2019. However, where audiologists are sparse, self-reported measures have been suggested as alternatives to assess burden. Moreover, research suggests this number varies by gender, due to biological and social mechanisms. Further refining our knowledge of the global prevalence of hearing loss will provide better understanding of which groups are most affected and how to best allocate resources.

Methods: Using Gateway to Global Ageing data and the South African National Income Dynamics Study, we estimated the prevalence and men:women ratio of self-reported hearing loss and hearing aid use for 28 countries. Hearing loss was measured as having fair/poor hearing or reporting hearing aid use. We included 664 580 observations of individuals aged 50+ years.

Results: We found that the four countries with the highest levels of hearing loss (China 65%, South Korea 39%, Mexico 33%, Brazil 31%) also had the lowest reported hearing aid use (as low as 1% in China). Though men were more likely than women to report hearing loss in nearly all countries, especially in regions with higher hearing aid use (USA, Northern/Western Europe), China, South Korea and South Africa reported no gender difference. As the prevalence of hearing loss and hearing aid use increased with age, gender differences generally decreased.

Conclusion: International variation underscores the importance of country context in shaping perceived hearing and hearing aid use. Regions with high levels of hearing loss and low hearing aid use may be especially amenable to interventions.