Disparities in Health Care Utilization Among Deaf and Hard of Hearing Adults

Abstract

Purpose: A substantial literature exists, documenting differences in access to quality health care among individuals of different racial/ethnic, residence, income, and disability groups. However, little attention has been given to disparate utilization among those who are deaf or hard of hearing (DHH). The purpose of this study was to evaluate differences between individuals with and without hearing-related issues using a nationally representative survey of health care access outcomes to quantify the magnitude of these differences. Method: Using data from the 2021 Centers for Disease Control Behavioral Risk Factor Surveillance System survey, we compared health care utilization between individuals who reported being DHH and those without hearing-related issues. Logistic regression models were used to explore differences in access to care between DHH and non-DHH individuals controlling for sociodemographic characteristics. Results: The total Behavioral Risk Factor Surveillance System survey sample consisted of 412,427 respondents. Among those were 36,532 (6.85%) who identified as DHH. Logistic models indicated that DHH adults were less likely to have a personal health care provider (odds ratio [ OR ] = 0.91, 95% CI [0.83–2.03]) and less likely to have received a routine checkup within the last 2 years ( OR = 0.91, 95% CI [0.82–1.02]) but more likely to have forgone health care due to difficulty paying ( OR = 1.90, 95% CI [1.71–2.06]) compared to those without hearing difficulties. Differences were robust to race, sex, and other demographic factors. Conclusions: Significant differences in health care utilization were observed between DHH and non-DHH individuals. This is concerning given that DHH adults have a higher prevalence of many chronic conditions that require clinical management. These results indicate that health care providers and systems must offer greater communication options to facilitate better health-related outcomes.