Journal
OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Volume -, Issue -, Pages -Publisher
WILEY
DOI: 10.1002/ohn.431
Keywords
gender disparities; health disparities; hearing loss; income disparities; population health; socioeconomic factors
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The study aimed to investigate the effects of gender and low-income status on general health care access in patients with hearing loss. The findings showed that females were more likely than males to face difficulties in affording prescribed medications and specialist care, and they were also more likely to delay care due to elder care responsibilities, employment obligations, and apprehension in seeing a provider. Additionally, low-income participants reported feeling less respected and having less understandable health information delivered by providers. These factors should be taken into consideration for promoting equity in the care of patients with hearing loss.
ObjectiveTo explore how gender and low-income status independently influence general health care access in patients with hearing loss. Study DesignCross-sectional study. SettingNational database. MethodsPatients with a diagnosis of sensorineural hearing loss from the National Institutes of Health All of Us database were included. Data entered from May 2018 to November 2022 was analyzed. Patient demographics such as age, gender, educational level, and insurance status were assessed. Multivariate logistic regressions were performed for statistical evaluation. ResultsA subset of 8875 patients (48.3% male, mean age 69) were evaluated. After multivariate analysis, female participants were more likely than male participants to report difficulty affording prescribed medications (odds ratio [OR]: 1.7, p < .0005) and specialists (OR: 1.4, p < 0.005). Female patients were also more likely to delay care due to elder care responsibilities (OR: 2.6, p < .0005), employment obligations (OR: 1.7, p < .0005), and feelings of apprehension in seeing a provider (OR: 1.7, p < .0005). Finally, female participants reported feeling less likely to be involved in their own medical care compared to males (OR: 1.2, p < .005). Low-income (<$25,000) participants reported less likely to feel respected (OR: 3.2, p < .0005) and delivered understandable health information (OR: 2.3, p < .0005) by providers compared to participants of higher income. ConclusionThis work suggests that patients with hearing loss, female gender, and lower socioeconomic status independently introduce barriers to health care access and utilization. These factors should be considered in efforts to promote equity in the care of patients with hearing loss.
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