RESUMO
OBJECTIVE: To explore the role of racial-ethnic background, income, residential context, and historic variation in hearing aid (HA) price HA usage among a nationally representative cohort of older adults with hearing loss. METHODS: Multilevel logistic regression models evaluated data from the 2012 through 2017 Medical Expenditure Panel Survey (MEPS) to 1) compare historic HA use between subgroups, 2) test for differential responsiveness to price changes between racial and ethnic groups, and 3) assess the relative role of demographic characteristics and HA use. RESULTS: Between 2012 and 2017, the price of economy HAs decreased by 5% while HA use among Non-Hispanic (NH) Whites and Hispanics with hearing loss increased by 30% and 20% respectively, but usage among NH-Blacks increased by less than 10%. After controlling for relevant covariates, NH-Blacks were two times less likely than NH-Whites to use a HA. Household income and price were only significant for NH-Whites who showed that a 1% increase in income was associated with a 10% increase in the likelihood of HA use. Calculation of subgroup participation showed that, when the price of HAs dropped by 1%, the likelihood of HA use by NH-Whites increased by 14.2%, Hispanics increased by 13.2%, and Others increased by 14.8%, but only 2.8% among NH-Blacks. CONCLUSION: Results suggest that cost is not the primary barrier to HA utilization among minoritized individuals from racial and ethnic groups. Additional analyses are needed to evaluate the role of social, cultural, and environmental influences on HA utilization.
RESUMO
BACKGROUND: It is reasonable to expect that deaf individuals require the use of vision for purposes other than those needed by hearing persons. For example, without the use of hearing, one would need to scan the environment visually to determine if someone was approaching rather than listening for footsteps or a name being called. Furthermore, these experiential differences could alter the development of neural organization of sensory systems of deaf persons. PURPOSE: To review the evidence-based literature in the area of visual attention and deafness with an emphasis on a series of visual attention studies utilizing several paradigms including the Continuous Performance Task, the Letter Cancellation Task, the Flanker Task, and a self-designed task of target identification in the periphery under distracter and nondistracter conditions conducted at Vanderbilt University. RESEARCH DESIGN: Systematic review. RESULTS: Collectively, the Vanderbilt studies pointed to a compensatory role that the visual system plays for deaf individuals. Specifically, the visual system appears to play an important role in directing a deaf individual's attention to the near visual periphery. CONCLUSIONS: Studies of visual attention in deaf individuals have been mixed in their conclusions about whether altered neural organization results in better or worse visual attention abilities by those who are deaf relative to those with normal hearing. The notion of across-the-board deficits or enhancements in the visual function of deaf individuals is not supported by the literature, nor is there support for the idea that fundamental visual sensory abilities such as acuity or light detection differ between deaf and hearing persons.
