Australian hearing loss statistics make for grim reading. The condition affects one in six Australians and, by 2050, it is expected to affect one in four.
Silence: Research shows only three in every 1000 GP consultations in Australia with patients aged 50 or older involve management of hearing loss despite the condition affeecting one in six people across the nation.
Hearing loss can be gradual and may not be obvious at first. Our early results from The Australian Eye and Ear Health Survey (AEEHS) indicate that nearly half the people screened who did not believe they had problems with their hearing had some level of hearing loss.
Hearing loss contributes to social isolation and loneliness, poorer mental health and a lower life expectancy.
It is also one of the top two modifiable risk factors for a dementia diagnosis. Research has shown that if an at-risk person is fitted with hearing aids and provided audiological counselling, this can slow loss of thinking and memory abilities by 48 per cent over three years.
Stigma delays treatment
Despite the clear benefits of treating hearing loss, the average person waits almost nine years from when they first notice problems before seeking assistance and treatment.
For many other health conditions, this would be unthinkable. So what makes us behave differently when it comes to our hearing?
Cost can be a factor, but it is not the only explanation. One of the main problems is how we think about hearing loss as a society.
Many of us view it not only as inevitable, but as an embarrassing sign of ageing. We feel that if we have hearing loss, we must be getting old, leading to denial.
Some people who are aware their hearing is deteriorating delay seeking testing and treatment because they are concerned about how others will perceive them if they use a hearing device. Others have a misperception that the devices will not be effective, or don't know where to seek advice.
The average person waits almost nine years from when they first notice (hearing) problems before seeking assistance and treatment. For many other health conditions this would be unthinkable.
And while age-related hearing loss is common due to changes in the ears and the nerve pathways leading to the brain, age is not the only cause.
There is a lack of understanding in the community about other causes, such as recreational and workplace-related noise, and how we can protect ourselves.
This year's World Hearing Day theme is Changing mindsets: Empower yourself to make ear and hearing care a reality for all! But what can we do to bring this about?
Changing our thinking
There are three key ways society can work towards a shift in our mindset: breaking down the stigma and stereotypes around hearing loss, improving the information available to both primary care providers and consumers, and better collection, sharing and analysis of data.
Loud and clear: Using artificial intelligence to analyse patient hearing data could lead to more personalised hearing treatment and better health outcomes, says Professor Gopinath, pictured.
Public education can play a vital role in challenging stereotypes and fostering a deeper understanding of the condition, but it is also important that we improve the way people understand and talk about their own hearing.
The Know your Hearing Numbers campaign in the United States is an example of this, encouraging people to have their hearing tested, to follow and understand changes over time and normalise talking about their hearing health.
There is no central information point for Australians with hearing loss. We aim to address this gap through a National Health and Medical Research Council (NHMRC) funded project, which began last year and involves developing an online support service to provide access to evidence-based, person-centred information and a range of resources such as peer-support forums and online self-assessment tools.
GPs as a source of help
As with many health conditions, GPs play a pivotal role in the early detection and management of hearing loss. Unfortunately, there is a lack of awareness among GPs, who are already extremely busy, and this can lead to delayed diagnosis and inadequate support. For example, our prior research shows that just three in every 1000 GP consultations in Australia with patients aged 50 or older involves management of hearing loss.
If GPs are to better assist patients, they need better evidence-based decision-support tools. Two international initiatives may help here: guidelines detailing who should undergo testing and referral for a cochlear implant, and a World Health Organisation (WHO) training manual on ear and hearing care for primary care providers.
For GPs to offer better-informed and more empathetic hearing care to patients, there is also a need for holistic education and training programs that cover the technical aspects of diagnosis and treatment, and the psychosocial implications of living with the condition.
Data has an important part to play. Improved collection and sharing of information across healthcare providers, hearing clinics and research studies would bring a better understanding of how people are using hearing services, and the barriers to treatment, both for individuals and in the health system.
If we can collect information from large numbers of patients, and take advantage of aspects of artificial intelligence and statistical modelling to analyse the data, it could lead to more personalised hearing treatment and better health outcomes.
By embracing these strategies, we can make the leap from a widespread view of hearing loss as an inevitable part of ageing to a better understanding of it as a condition that can be treated – and, in some cases, prevented.
Professor Bamini Gopinath is Inaugural Cochlear Chair of Hearing and Health at Macquarie University Hearing.
