Centre for Primary Care and Health Services Research, Institute for Health Policy and Organisation (IHPO), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
Institute for Health Policy and Organisation (IHPO), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
Trends Hear. 2021 Jan-Dec;25:23312165211002963. doi: 10.1177/23312165211002963.
Hearing loss is a major health challenge that can have severe physical, social, cognitive, economic, and emotional consequences on people's quality of life. Currently, the modifiable factors linked to socioeconomic inequalities in hearing health are poorly understood. Therefore, an online database search (PubMed, Scopus, and Psych) was conducted to identify literature that relates hearing loss to health inequalities as a determinant or health outcome. A total of 53 studies were selected to thematically summarize the existing literature, using a critical interpretive synthesis method, where the subjectivity of the researcher is intimately involved in providing new insights with explanatory power. The evidence provided by the literature can be summarized under four key themes: (a) There might be a vicious cycle between hearing loss and socioeconomic inequalities and lifestyle factors, (b) socioeconomic position may interact with less healthy lifestyles, which are harmful to hearing ability, (c) increasing health literacy could improve the diagnosis and prognosis of hearing loss and prevent the adverse consequences of hearing loss on people's health, and (d) people with hearing loss might be vulnerable to receiving low-quality and less safe health care. This study uses elements from theoretical models of health inequalities to formulate a highly interpretive conceptual model for examining hearing health inequalities. This model depicts the specific mechanisms of hearing health and their evolution over time. There are many modifiable determinants of hearing loss, in several stages across an individual's life span; tackling socioeconomic inequalities throughout the life-course could improve the population's health, maximizing the opportunity for healthy aging.
听力损失是一个重大的健康挑战，会对人们的生活质量造成严重的身体、社会、认知、经济和情感后果。目前，与听力健康的社会经济不平等相关的可改变因素还了解甚少。因此，我们进行了在线数据库检索（PubMed、Scopus 和 Psych），以确定将听力损失与健康不平等作为决定因素或健康结果相关的文献。共选择了 53 项研究，采用批判性解释性综合方法对现有文献进行主题总结，该方法密切涉及研究人员的主观性，以便提供具有解释力的新见解。文献提供的证据可以总结为四个关键主题：(a) 听力损失和社会经济不平等以及生活方式因素之间可能存在恶性循环；(b) 社会经济地位可能与更不健康的生活方式相互作用，这些生活方式对听力能力有害；(c) 提高健康素养可以改善听力损失的诊断和预后，并防止听力损失对人们健康的不利后果；(d) 听力损失者可能容易接受低质量和不安全的医疗保健。本研究使用健康不平等理论模型的要素来制定一个高度解释性的概念模型，以检查听力健康不平等。该模型描述了听力健康及其随时间演变的具体机制。听力损失有许多可改变的决定因素，在个体的整个生命周期中处于不同阶段；在整个生命周期中解决社会经济不平等问题可以改善人口健康，最大限度地实现健康老龄化的机会。
