Lewis Charity T, Jang Yuri, Elayoubi Joanne, Sanchez Victoria A, Arnold Michelle L, Toman Julia, Haley William E
School of Aging Studies, University of South Florida, Tampa, Florida, USA.
Auditory Rehabilitation and Clinic Trials Laboratory, University of South Florida, Tampa, Florida, USA.
Gerontologist. 2025 Apr 9;65(5). doi: 10.1093/geront/gnaf029.
To better understand racial/ethnic disparities in hearing aid use, we examined racial differences in discrepancies between subjective hearing ratings and objective hearing tests as a potential source of this disparity.
A cross-sectional assessment was conducted using the data from the Health and Retirement Study (HRS). Our analytic sample included 2,568 participants aged 50 and older: 1,814 non-Hispanic White Americans and 754 non-Hispanic Black Americans. Discordant groups were identified based on self-ratings of hearing abilities (positive vs negative) and objective hearing test results (normal vs hearing loss).
Analysis of HRS data revealed that approximately 73% of participants with objectively measured hearing loss reported positive hearing ratings. False positive hearing rates were found to be 80% among Black older adults and 70% among their White counterparts. Odds for false positive hearing ratings were significantly greater for Black older adults, men, those with less than a high school education, more health conditions and depressive symptoms, and current smoking. Racial differences were maintained after adjustment for these covariates.
While cost of hearing aids has been a predominant explanation of low hearing aid use in Black Americans, false positive perceptions of hearing abilities may also play a significant role as a psychosocial mechanism. Future studies examining racial/ethnic differences in possible psychosocial mechanisms for discrepancies between objective and subjective hearing could guide the development and evaluation of culturally appropriate educational interventions.
为了更好地理解助听器使用方面的种族/族裔差异，我们研究了主观听力评级与客观听力测试之间差异的种族差异，将其作为这种差异的一个潜在来源。
使用来自健康与退休研究（HRS）的数据进行横断面评估。我们的分析样本包括2568名50岁及以上的参与者：1814名非西班牙裔美国白人以及754名非西班牙裔美国黑人。根据听力能力的自我评级（阳性与阴性）和客观听力测试结果（正常与听力损失）确定不一致组。
对HRS数据的分析显示，在客观测量有听力损失的参与者中，约73%报告听力评级为阳性。发现黑人老年人的假阳性听力率为80%，白人老年人为70%。黑人老年人、男性、高中以下学历者、健康问题和抑郁症状较多者以及当前吸烟者出现假阳性听力评级的几率显著更高。在对这些协变量进行调整后，种族差异依然存在。
虽然助听器成本一直是美国黑人助听器使用率低的主要解释，但听力能力的假阳性认知作为一种心理社会机制可能也起到了重要作用。未来研究客观与主观听力差异可能的心理社会机制中的种族/族裔差异，可为制定和评估适合不同文化的教育干预措施提供指导。
