What to Know About Racial Disparities in Hearing Aid Access

Explaining disparities in hearing aid use

It’s unclear exactly why older Black and Hispanic adults with hearing loss aren’t getting adequate care. “There are noted racial gaps in health care penetration,” Kumar says, and hearing aid access seems to be just one example. 

Experts do know, however, what’s not entirely to blame for the gaps in care. For one, it doesn’t seem to be that minority populations are more likely to live in hearing care “deserts,” the same way they are more likely to live in food deserts, or areas with sparse access to healthy, affordable food. 

Other research conducted by Reed and colleagues found that between 2011 and 2022, hearing aid use increased among older adults in metropolitan areas — which tend to be more highly populated by racial and ethnic minorities  — while decreasing among low-income Americans in non-metropolitan areas. And yet, that increase in hearing aid adoption in urban settings doesn’t seem to have benefited older residents of color. 

“The majority of audiology services are really urban,” says Reed, noting that the nation’s big audiology training programs are in cities like New York (NYU), Chicago (Northwestern) and Baltimore (Johns Hopkins). “So you end up with a lot of audiology services that, in theory, are in proxy to some of the larger minority populations in this country. But yet, we’re not seeing that translate into higher levels of care.” 

Cost doesn’t explain differences

The cost of hearing aids doesn’t always explain racial disparities either. One 2023 study showed that when hearing aid prices dropped, there was significant uptick in usage among white and Hispanic adults with hearing loss — 14.2 percent and 13.2 percent, respectively. At the same time, the price decrease only correlated with a 2.8 percent increase in usage among non-Hispanic Black participants. 

“It’s a much deeper sort of systemic divide in this country than just things like purely proximal access,” Reed says. “There’s clearly another barrier.”

How to find hearing solutions that work for you — regardless of race 

Approach OTC options with caution

In part because the US Food and Drug Administration doesn’t regulate hearing aids the way it approves new drugs — clinical trials and all — the bar is low for manufacturers who want to create and sell them, Reed says. While that’s not such a problem for people who work with an audiologist to help them filter through the figurative noise and find the right fit, it introduces more risk when folks shop for a device at Walmart.

“You end up with this opportunity for predatory markets and anybody who can build a device that meets those not super-strong minimum specs, they could just sell it over the counter,” Reed says. “And what we ended up with instead was an over-the-counter market of hearing aids that run the gamut. There are good ones out there, but there are dozens and dozens and dozens of junky ones out there.”  (For more, see How to Shop for an Over-the-Counter Hearing Aid.)

Look for “self-fitting” label

If you want to try an over-the-counter product, look for one with a label that says “self-fitting,” Reed recommends. That designation “actually requires trial-level proof that you do what you'll say you do,” he says. The catch is that few manufacturers justify spending the time and money on acquiring that level of evidence, when they could just go straight to market and assume — often correctly — that consumers don’t know the difference, Reed says. 

Try Apple’s new product — especially if you already have it

Just this fall, Apple released its AirPods Pro 2 earbuds, which can double as hearing aids — and rather successfully, Reed finds. “It's a wonderful piece to the market, and if you're going to have that phone anyway and pay for it, then it makes perfect sense,” he says. But it’s not a catch-all solution, especially for people who don’t already have the hardware. It’s also not meant for people with severe hearing loss.

Know your hearing score

Hearing loss can creep up on you. “You do not notice the day-to-day, the week-to-week, the year-to-year” declines, Reed says. “It’s one of those things where, 10 years down the road, you’re like, oh my gosh, something’s really changed.”

It’s important to keep tabs on your auditory health along the way by, for example, knowing your “hearing number,” which tells you the softest speech sound you can hear. A hearing professional can conduct a test to determine your number, which is typically cheap and mostly covered by Medicare.

You may want to start with the AARP hearing test. It's available over the phone and free for AARP members once a year, $8 for others. The National Hearing Test was developed with financing from the National Institutes of Health and can be taken without an appointment. Various apps are available that can gauge your score as well. “One of the first steps in hearing care is …understanding your own hearing loss,” Reed says. 

See a professional

When in doubt, see an audiologist if you can. Even your primary care provider can help guide you to the right support. Just be sure to tell them about any early exposures to loud noises (like work on a construction site or in a music venue) in the past and keep caring for your ears (like by wearing ear plugs in loud environments) in the meantime, Kumar suggests.

If a clinician does believe hearing aids are in your future, the appropriate ones for you “can really expand and improve your quality of life as you get older by preserving your hearing at an earlier age,” Kumar says.