Barriers to hearing aid adoption in hearing loss
Clinical Snapshot
PICO Framework
| P — Population | Adults with hearing loss in the United States |
| I — Intervention | Not applicable - this is a narrative review |
| C — Comparator | Not applicable - this is a narrative review |
| O — Outcomes | Barriers to hearing aid adoption including knowledge gaps, screening inadequacy, stigma, cost, and usability issues |
Bottom Line
This narrative review identifies five key barriers preventing hearing aid adoption among the 20% of Americans with hearing loss: inadequate health knowledge, insufficient screening, social stigma, high costs, and device usability challenges. While hearing loss significantly increases risks of falls, depression, cognitive decline, and mortality, fewer than 10% of affected individuals use hearing aids despite evidence that treatment improves outcomes. The review lacks systematic methodology but provides a useful clinical framework for understanding why patients resist hearing aid adoption. For Australian clinicians, these barriers are equally relevant given similar healthcare contexts. The identification of recent policy changes suggests opportunities for improvement, though the narrative format limits the strength of evidence for specific interventions. Clinicians should consider these barriers when counselling patients about hearing loss treatment and advocate for system-level changes to improve access and uptake.
Key Findings
P Value: Not applicable - narrative review
Effect Size: Less than 10% of Americans with hearing loss use hearing aids
Primary Outcome: Five key barriers to hearing aid adoption identified
Nnt Or Sensitivity: More than one-fifth of US population affected by hearing loss
Confidence Interval: Not applicable - narrative review
Clinical Application
Barrier identification can inform clinical practice and health policy interventions Highly relevant to Australian practice - similar healthcare challenges exist with PBS subsidies for hearing aids, RACGP screening guidelines, and audiologist referral pathways Adults with hearing loss in developed healthcare systems
Abstract
More than one-fifth of the US population has hearing loss, a condition associated with higher risk of falls, depression, isolation, cognitive decline, dementia, and all-cause mortality. Treatment of hearing loss has been shown to correlate with decreased risk of cognitive decline, dementia, and mortality, as well as an improved quality of life. Surprisingly, however, fewer than 1 in 10 Americans with hearing loss use hearing aids. As the prevalence and burden of hearing loss grow, clinicians must understand factors influencing hearing aid use to increase treatment rates. This article reviews key barriers to hearing aid adoption-including low hearing health knowledge, inadequate screening, stigma, cost, and difficulty of use-and discusses recent changes that may influence these barriers.
References
- 1.Canavan, J., & Dempsey, S. A. (2026). Barriers to hearing aid adoption in hearing loss. JAAPA, 39(5). https://doi.org/10.1097/01.JAA.0000000000000349
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