The Secret to Getting Men to Wear Hearing Aids

Sustainable Development Goals and the Importance of Hearing Aid Accessibility

Introduction

Richard Einhorn first noticed that he was losing his hearing in a way that many others do—through a missed connection, when he couldn’t make out what a colleague was saying on a phone call. He was 38, which might seem early in life to need a hearing aid but in fact is common enough. His next step was common too. “I ignored it,” Einhorn, now 72, told me. “Hearing loss is something you associate with geezers. Of course I hid it.” He didn’t seek treatment for seven years.

The Impact of Hearing Loss

About 15 percent of Americans, or nearly 53 million people, have difficulty hearing, according to the CDC. Yet an AARP survey found that Americans older than 40 are more likely to get colonoscopies than hearing tests. Even though hearing starts to deteriorate in our 20s, many people think of hearing damage as a sign of old age, and the fear of being seen as old leads people to delay treatment. According to the Hearing Loss Association of America, people with hearing loss wait, on average, seven years to seek help, just as Einhorn did.

When people ignore their hearing loss, they put themselves at a higher risk for social isolation, loneliness, and even dementia. One of the best things you can do to feel less old is, ironically, get a hearing aid. And in the past two years, these devices have become cheaper, more accessible, and arguably cooler than they’ve ever been, even before the FDA approved Apple’s bid last week to turn AirPods into starter hearing aids. This new technology is more of a first step than a complete solution—think of it as analogous to drugstore reading glasses rather than prescription lenses. That, more than anything about AirPods themselves, may be the key to softening the stigma around hearing aids. Creating an easier and earlier entry point into hearing assistance could help Americans absorb the idea that hearing loss is a spectrum, and that treatment need not be a rite of passage associated with old age.

Addressing the Stigma and Barriers

As it stands, one demographic that could especially benefit from destigmatized hearing aids is older men. “Men are at a greater risk for hearing loss early on because they have typically had more noise exposure than women,” says Steven Rauch, who specializes in hearing and balance disorders at Harvard Medical School. But men are also less likely to go to the doctor. (Several men I interviewed spoke about being prodded by their wives to go to an audiologist.) Instead, many hide their hearing loss by nodding along in conversation, by hanging back at social gatherings, by staying home.

Faking it makes the situation worse. Without treatment, hearing can decline, and people become socially isolated. “When you’re sitting in a room and people are talking and you can’t participate, you feel stupid,” says Toni Iacolucci, a communication-access advocate who waited a dozen years before she got a hearing aid. “The amount of energy you put into the facade that you can hear is just exhausting.”

Compensating for untreated hearing loss is so taxing, in fact, that it can have a meaningful impact on the brain. “Hearing loss is arguably the single largest risk factor for cognitive decline and dementia,” says Frank Lin, the director of the Cochlear Center for Hearing and Public Health at Johns Hopkins University. Lin and his colleagues have found that mild hearing loss doubles the risk of dementia, and moderate loss triples it. In this context, a hearing aid can look almost like a miracle device for slowing aging: In that same study, Lin also found that among older adults at increased risk for cognitive decline, participants who wore a hearing aid for three years experienced about 50 percent less cognitive loss than the control group.

Improving Accessibility and Normalizing Hearing Aids

That anyone is straining this much when a fix exists is a testament to how powerful ageism and the pressure to project youth can be. As long as people see the choice as one between hearing well and looking young, many will opt for faking their ability to hear. Overcoming that association with age may be the last challenge of persuading people to try hearing aids out.

Some of the barriers were, until recently, more basic. Hearing aids were available only with a prescription, which usually requires visits to an audiologist who calibrates the device. Prescription hearing aids also cost thousands of dollars and aren’t always covered by insurance. But these barriers are getting lower. In 2022, the FDA approved the sale of hearing aids to adults without a prescription, opening the technology up to industry for the first time. Over-the-counter options have now hit the market, including from brands such as Sony and JLab. Apple’s hearing-aid feature, compatible with some AirPod Pros, is the first FDA-approved over-the-counter hearing-aid software device and will be available later this fall via a software update. EssilorLuxottica plans to release the first-ever hearing-aid eyeglasses later this year.

None of that undoes hearing aids’ association with aging though. A selling point of the new AirPod technology is simply that “everybody wears AirPods,” Katherine Bouton, a hearing-loss advocate and the author of the memoir Shouting Won’t Help, told me. “The more you see people wearing something, the more normal it becomes.” At the same time, AirPods are typically a signal that someone’s listening to music or a podcast rather than engaging with the world around them: The AirPods might improve someone’s hearing, but they won’t necessarily make hearing loss less lonely. Even if Iacolucci’s hearing loss could be treated with AirPods, she doesn’t think they would fully address the loss’s impact: “I still have to deal with the internal stigma, which is a thousand times worse,” she told me.

The real power of the Apple technology, then, might be that it’s targeted to users with mild to moderate hearing loss. Changing the stigma around hearing loss will take far more than gadgets: It’ll require a shift in our understanding of how hearing works. “Hearing loss implies that it’s binary, which couldn’t be further from the truth,” Lin said. Most people don’t lose their hearing overnight; instead, it starts to deteriorate (along with the rest of our body) almost as soon as we reach adulthood. Over time, we permanently damage our hearing through attending loud concerts, watching fireworks, and mowing the lawn, and the world is only getting louder. By 2060, the number of Americans ages 20 years and older with hearing loss is expected to increase by 67 percent, which means that nearly 30 million more people will need treatment. If devices we already use can help people transition more easily and at a younger age to using hearing assistance, that could make the shift in identity less stark, easing the way to normalizing hearing aids and changing the idea that they’re for geezers only.

SDGs, Targets, and Indicators

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 10: Reduced Inequalities
• SDG 11: Sustainable Cities and Communities
• SDG 17: Partnerships for the Goals

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
• SDG 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
• SDG 11.7: By 2030, provide universal access to safe, inclusive and accessible, green and public spaces, in particular for persons with disabilities.
• SDG 17.17: Encourage and promote effective public, public-private and civil society partnerships, building on the experience and resourcing strategies of partnerships.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Indicator for SDG 3.4: Prevalence of hearing loss and access to hearing aids.
• Indicator for SDG 10.2: Proportion of population with access to affordable and quality assistive devices, including hearing aids.
• Indicator for SDG 11.7: Proportion of persons with disabilities who have access to public spaces and facilities.
• Indicator for SDG 17.17: Number of partnerships and collaborations established to promote access to hearing aids and address the stigma around hearing loss.

Table: SDGs, Targets, and Indicators

Source: theatlantic.com