Annals of Otology, Rhinology & Laryngology 2016, Vol. 125(9) 716–721 © The Author(s) 2016 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0003489416649972 aor.sagepub.com Article Introduction Hearing loss in adults can affect quality of life, occupa- tional performance, social interaction, cognition, and mental health. 1-3 Multidisciplinary evaluation including hearing testing and a primary care or otolaryngology pro- vider examination is prudent to identify the cause. Hearing rehabilitation is effective treatment for hearing loss, but only if those in need are identified and provided affordable solutions for their hearing loss. With the impending entrance of the baby boom generation into the “senior” age cohort, the US government has promoted specific goals and programs to bolster hearing health. HealthyPeople 2020 is a government-supported initiative that promotes 10-year objectives for improving the health of Americans. 4 Current objectives related to hearing health call for 10% increases in the proportion of adults who use a hearing aid or assistive devices, the proportion of deaf or very hard of hearing adults who receive and utilize cochlear implants, and the proportion of adults who have hearing examina- tion in the past 5 years. The investigation of availability of hearing services for adults has revealed a variety of difficulties in obtaining hearing services. Primary care physicians may not be routinely conducting hearing and/or balance screenings as part of Medicare preventive physical examinations, leaving a significant opportunity for early intervention unused. 5 Over 55% of adults aged 70 years or older and 34% of all adults aged 18 years or older in the Beaver Dam Offspring Study in Wisconsin reported no hearing test within the past 5 years. 6 Only about one-third of potential adult hearing aid candidates reported using hearing aids in another recent study, and hearing aid use may have been associated with higher socioeconomic status. 7 When considering the inverse, work with the deaf community has shown basic health care access difficulties secondary to communication and sociocultural issues. 8 Hard of hearing individuals who may not necessarily be deaf have also been shown to report difficulties with accessing basic health care. 9 649972AOR XX X 10.1177/0003489416649972Annals of Otology, Rhinology & LaryngologyCrowson et al research-article 2016 1 Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA Corresponding Author: Matthew G. Crowson, Division of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, 2301 Erwin Road, Durham, NC USA 27710, USA. Email: matthew.crowson@dm.duke.edu Access to Health Care and Hearing Evaluation in US Adults Matthew G. Crowson, MD 1 , Kristine Schulz, DrPH, MPH 1 , and Debara L. Tucci, MD, MS, MBA 1 Abstract Objectives: To explore self-reported hearing testing access for adults in a nationally representative survey. Methods: Demographic and audiologic adult survey respondent variables in the National Health and Nutrition Examination Survey (NHANES) database 2011-2012 cohort were examined. Logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI). Results: In all, 5864 adult respondents were analyzed. Two-thirds (65.6%) of respondents reported having hearing tested 10 or more years ago or never tested at all. Male gender (OR = 2.27; 95% CI, 1.31-3.94), having a health care visit less than 3 years ago (OR = 8.19; 95% CI, 2.09-32.2), and having health insurance (OR = 1.73; 95% CI, 1.08-2.77) were significantly associated with respondents reporting having a hearing test less than 10 years ago. Mexican American race (OR = 0.41; 95% CI, 0.20-0.83) and respondent age 40 to 59 (OR = 0.52; 95% CI, 0.33-0.81) were significantly associated with respondents reporting having a hearing test 10 or more years prior or never. Conclusion: A significant proportion of the adult population reports having hearing tested 10 or more years prior or never at all. Effort will be required to identify adults who have hearing loss and may benefit from auditory rehabilitation such as hearing aids or the cochlear implant. Keywords hearing loss, hearing impairment, hearing aids, health care, otology, otolaryngology by guest on August 2, 2016 aor.sagepub.com Downloaded from