Racial-Ethnic Disparities in Hearing Aid Use: Price Responsiveness Among Older Adults with Hearing Loss

ObjectiveTo 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.MethodsMultilevel 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.ResultsBetween 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.ConclusionResults 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.