Sarah Silva spent a night out with her friends at a sports bar. As she tried to enjoy the games, she was overwhelmed by noise from the crowds, televisions and restaurant.
As someone with moderate hearing loss, she called it a “nightmare listening situation.”
“It’s hard even if you have normal hearing,” said Silva, the executive director of GiveHear, a local nonprofit audiology clinic. “If you have hearing loss, it’s absolutely impossible. So, it’s like, why do you even come?”
More than 18% of Hoosiers have some sort of hearing loss, which is above the national average of 15.9%, according to the National Council on Aging.
Hearing loss is categorized in seven different degrees, according to the American Speech-Language-Hearing Association. The degrees are normal, slight, mild, moderate, moderately severe, severe and profound.
The degrees are measured by hearing loss in decibels, and it shows the range of the softest sounds someone can hear.
SoundCheck, a research project led by the National Opinion Research Center at the University of Chicago, found in January that hearing loss affects nearly 38 million people nationwide and is more common in men and those who live in rural areas.
Dr. Charlotte Thompson, an audiologist at GiveHear, said fewer people living in rural areas might affect the total. She said the types of jobs they have also differ from those in urban areas and are more often in factory work, manufacturing or farming.
Blue-collar jobs typically have more noise exposure, which can lead to increased rates of hearing loss, Thompson said. At GiveHear, she treats patients whose jobs expose them to more noise.
“There are regulations for those facilities, and they have to be wearing hearing protection,” she said. “But we do see patients who potentially were exposed to recreational noises or they didn’t wear their hearing protection.”
Access to care can also affect hearing loss, Thompson added.
“That appointment could be two hours away, and they have to worry about whether they can get transportation to that type of appointment,” she said. “Sometimes, they may have to take half a day off of work. … Those people, I would say, are more impacted.”
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Silva and Thompson both said they believe hearing health is undervalued, especially by people who don’t have disposable income. They also think it’s important to get hearing tests as soon as possible.
Common hearing loss symptoms include muffling of speech, needing to turn up the volume on the television or being bothered by background noise, according to the Mayo Clinic.
“Research does indicate that if hearing loss goes untreated for an extended period of time, there’s more of a cognitive decline for those patients,” Thompson said. “It’s the concept of if you don’t use it, you lose it, just like a muscle.”
Beltone, a Chicago-based hearing aid company, has locations in Fort Wayne and Auburn. David Lowry, hearing care practitioner, said Beltone has been in northeast Indiana for 17 years, and the business provides free hearing tests and sells and fits hearing aids.
Fort Wayne has more than 20 clinics that provide hearing tests, including Summit Hearing Solutions, Carter Hearing Clinics and Indiana Ear, in addition to Beltone and GiveHear.
Hearing tests help audiologists determine how severe someone’s hearing loss is. Audiologists use several types of tests, including pure-tone, bone conduction and speech.
Pure-tone finds the quietest volume one can hear, bone conduction sees if someone has wax or fluid blocking the outer or middle ear, and speech requires listening to and repeating certain words.
Some sounds people with hearing loss can’t hear include voices of women and children, birds chirping or certain musical instruments.
Infants and children usually get hearing tests, but Lowry said the assessments are important at all ages.
“Everyone needs to get a baseline to know where they’re at,” Lowry said. “There’s a lot of other health effects that go along with hearing loss that we like to prevent as well.”
Those potential effects include heart disease, diabetes and dementia, he added.
Heart disease can lead to compromised blood flow to the cochlea, a cavity in the inner ear, according to the National Institutes of Health. High blood sugar levels connected with diabetes can damage small blood vessels and nerves in the inner ear, said the Centers for Disease Control and Prevention.
A 2023 study from the Johns Hopkins Bloomberg School of Public Health shows that dementia is more common in those with moderate or severe hearing loss. The connection between the two still isn’t clear, study findings said.
Karen Horvath, director of DeafLink at The League, said hearing loss can affect anybody. Both men and women can acquire it, and although elderly people are more at risk because of their age, anyone can experience it at any age.
Deaf people have profound hearing loss, which is the most severe degree, according to the World Health Organization.
Services can look completely different depending on age, Horvath said. Those who are hard of hearing have mild to severe loss, and they can benefit from hearing aids, cochlear implants or other assistive devices.
Those who are deaf or have profound hearing loss typically use American Sign Language.
“If you’re deaf from birth, you might be a fluent (American Sign Language) user,” Horvath said. “In contrast, there’s the older population that becomes deaf later and now doesn’t have access to communication. They can get frustrated and feel like it’s too late to learn how to sign.”
DeafLink provides services to those who are deaf or have some kind of hearing loss. Its services include interpreting, case coordination and sign language classes. The program became part of The League in 2006 and has nearly 40 interpreters, including staff members, interns and freelance contractors.
Most of DeafLink’s clients are from Allen County, Horvath said, but staff travel farther if needed.
“The interpreter pool is predominantly in city areas, and as you go further out, it’s harder to get an interpreter there,” she added. “We are recruiting and adding our interpreters to various areas because we try to have people closer to where we know there are deaf people.”
Nationwide, there is a shortage of American Sign Language interpreters, Horvath said. Indiana has 199 certified interpreters for the deaf, while surrounding states in the Great Lakes region all have more than 200, according to Deaf Services Unlimited.
The National Census of the Deaf Population found about 500,000 people are deaf or hard of hearing and use American Sign Language. The ratio of interpreters to users is roughly 50-to-1, the census found.
More schools are starting to teach American Sign Language, which Horvath said she believes is making people focus on hearing health more. Horvath regularly works in schools, and she said students can identify if someone in the class has hearing loss.
People are starting to think about hearing loss at younger ages as well, Horvath said.
“There’s more information out there than before,” she said. “You see little kids wearing noise-canceling headphones. I don’t even think I had those when I was a mom of young kids. I think the message is getting out there, and people are seeing that it’s important to take care of your hearing.”
Young children aren’t the only ones who should use hearing protection. The Occupational Safety and Health Administration requires employers to implement hearing conservation programs when noise exposure is at or above 85 decibels averaged over eight working hours.
People should use hearing protection in other loud settings, including auto races, concerts or shooting sports, according to the National Institute on Deafness and Other Communication Disorders. Hearing protection includes noise canceling headphones and earplugs.
Lowry believes people have focused on hearing loss more in the last couple of years.
“There’s been a lot more educational studies, and more people are becoming health conscious,” he said.
Although more people might be more health conscious now, Lowry said hearing care still appears to be at the bottom of most people’s priority lists.
“They just don’t notice it,” he said. “Hearing loss is an invisible problem. It happens gradually, so it takes time for people to notice it happening.”
