Assessment of Hearing Health Among Adults in Rural Health Clinics

Objective: Hearing loss (HL) negatively impacts all aspects of health, yet poor access to hearing healthcare (HHC) among adults is a pervasive public health problem. The inaccessibility of HHC is amplified in rural adults. Rural health clinics (RHC) are a critical healthcare system tasked with improving health in rural communities and the objective of this study is to assess the prevalence of HL and the utilization of HHC within RHCs. Methods: Using cross-sectional study design, adults were recruited from 10 RHC throughout rural Kentucky, mostly within Appalachia. The primary outcomes were (1) presence of HL on screening and (2) history of a hearing test within the last year and within the last 5 years. Additional outcomes included sociodemographic and overall health status. Descriptive, univariate, and multivariate analyses were conducted. Results: A total of 403 participants (mean age 51.1) were recruited. A total of 388 participants completed a hearing screening and 271 (70%) screened positive for HL, yet only 3.4% and 13.4% of participants had undergone a hearing test in the past 1 and 5 years, respectively. Adults with higher education levels were less likely to have HL (OR 0.47; 95% CI 0.26–0.86; p = 0.02). HL in this sample was associated with noise exposure (OR 1.97; CI 1.08 to 3.61; p = 0.03) and poorer mental health (OR 3.48; 95% CI 1.74–7.18; p = 0.001). Conclusion: Rural adults in RHC have a high prevalence of HL and low utilization of HHC. Promoting and expanding access to HHC within RHCs may improve hearing health among rural adults. Level of Evidence: 3.