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Prepared by: Linda S. Heller, M.A.C.C.C.A.,C.M.
Hearing Loss Association of America-Wilmington Chapter (302) 292-3066 (Ph/Fax) (Email)

Hearing Loss is a complex medical condition and only recently has been more accurately quantified. According to Webster's dictionary, deafness (hearing loss) is defined as "lacking or deficient in the sense of hearing."

In reference to determining the projected or actual number of people with hearing loss, it is important to note the following:

1. That many people claim their hearing is fine, when it isn't,

2. That some people may pass a hearing screening and still have a hearing loss because standard pure tone hearing screening only checks 4 frequencies and screening does not detect hearing loss at all pitches; also some people can not be tested with a traditional hearing screening because they may not respond appropriately, and it is generally considered that we get about a 3% false positive rate when doing traditional hearing screening.

3. That research is showing that hearing loss has a higher prevalence than was thought for years. We used to figure that in the general population, it was 10% and all our extrapolations were based on that. Indeed, the 85,000 I have estimated since about 2004 is now considered too low. It is now thought that we should use 16% estimate.

4. When you quoted the American Community Survey (ACS) that is based on a SAMPLING of people that SELF-REPORT hearing loss, therefore, you are reporting "incidence", meaning the actual number of times that people "self-reported" having a hearing loss. Unlike the every-10-year census, the ACS survey continues all year, every year.

ACS survey is sent out each month and surveys about 3 million Americans randomly each year. So the 63,000 or so that is often cited by Delaware advocates from the ACS survey is based on people who acknowledge or think they have a hearing loss based on their experience.

The number of people who know they have a hearing loss tends to be less than the number of people who actually do have a hearing loss. For more information on the ACS go to the following link:

It is important to note that incidence and prevalence are two different terms with different statistical meanings. Many people tend to not know or confuse the difference statisticians and epidemiologists use for the two terms.

Incidence is defined as:

"the actual number of times something happens or develops: the rate at which something occurs"

Prevalence is defined as:

"the degree to which something is prevalent; especially: the percentage of a population that is affected with a particular disease at a given time."

Therefore, if we base the number of Delawareans of ALL AGES with a hearing loss and the DE 2010 population was considered to be 895,173, then based on the 16% (prevalence) of people of all ages, then the number of people estimated to have a hearing loss significant enough to fail a standard hearing screening in Delaware would be 143,228.

Gallaudet University Research Institute website cites US Census, National Health Interview Survey (NHIS) or the Survey of Income and Program Participation (SIPP) data with the following chart below @ estimating the prevalence of deaf and hard of hearing people:

Keep in mind that 16% is the AVERAGE but in certain age ranges, such as young children prone to have repeated episodes of ear infections (otitis media), older adults 60 and over, and teens exposed to loud noise levels for example, up to 30% of these individuals and as high as 50% are projected to have significant hearing losses.

Projections in every age category for Delawearans have not been made, but HLAA-Delaware Chapters can provide them if people request it. Indeed, in the Crews and Campbell article cited below of people 79 years and over, 18% reported some form of blindness, whereas 33.2% of this population reported blindness.

Source: On the Pub Med website, the National Institutes of Health, in a research article entitled- "Vision Impairment and Hearing Loss Among Community-Dwelling Older Americans: Implications for Health and Functioning* by John E. Crews, DPA and Vincent A. Campbell, PhD (National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia/2003 reported the following:

"Sensory problems are common experiences within the older US population. Of people aged ? 70 years, 18% report blindness in 1 or both eyes or some other trouble seeing, 33.2% report problems with hearing, and 8.6% report problems with both hearing and seeing. Precisely because these experiences are so common, they are often overlooked or dismissed."

This finding was based on a research article that Campbell and Crews wrote in 1999 that reviewed and analyzed the 1994 National Health Interview Survey (NHIS) Core, NHIS disability supplement (NHIS-D1), and the 1994 NHIS Second Supplement on Aging (SOA II) were used to estimate vision impairments, hearing loss, and activity limitation. Data from the Behavioral Risk Factor Surveillance System (BRFSS) for 1993 through 1997 was also reviewed.

It is estimated that about 1-2% of the population with hearing loss is considered to be deaf, meaning they were born deaf on or before the age of 3 years of age and may use or have chosen to use American Sign Language (ASL) as their primary mode of communication OR they were born deaf on or before the age of three and chose to use the auditory-verbal known as the "oral method" of communication.

Additionally, hearing or deaf parents of some children born deaf also choose the auditory/verbal method of communication for their children. These children will tend to wear hearing aids or cochlear implants. Based on the overall hearing impaired Delaware population prevalence of 143,228, a 2% maximum prevalence, then there are about 2865 deaf Delawareans.

The incidence of the remaining 98% of people with hearing loss are considered to be hard of hearing, meaning they tend to use the spoken word as their primary mode of communication and function primarily in the hearing world. There are also some people with a severe hearing loss or that are both deaf and blind or has other development or multiple disabilities that may choose to use American Sign Language.

Also, keep in mind that there is a medical, functional and social definitions of hearing loss, deafness, deaf and hard of hearing so people tend to use these definitions in many ways and interchangeably and that leads to more confusion and sometimes result in disagreements because people have or conceive of a different meaning and reference for the same word.

Hearing loss is a medical term but many deaf people do not want to be referred to as having a "hearing loss," because they feel they are "normal meaning normal intelligence and in other ways, they just can't hear. So this term should not be used in communities where cultural sensitivity of language should be considered.

The Annual Survey of Deaf and Hard of Hearing Children and Youth (1999-2000). This was the first national estimate that fully utilizes the distinction between children having deaf parents and hard of hearing parents, as well as hearing parents.

The authors propose that the key demographic to report, other than that the overwhelming majority of deaf and hard of hearing students have hearing parents, is whether the child has one or two deaf parents.

The Annual Survey findings indicate that less than five percent of deaf and hard of hearing students receiving special education are known to have at least one deaf parent, which is less than half of the presumed ten percent ("The Mythical Ten Percent," Gallaudet University Research Institute, 2002.

   For further information on any aspect of hearing loss contact your hearing aid dispenser or Hearing Loss Association of America - Delaware at 302-292-3066 (V/relay) or email

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Hearing Loss - An Issue of National Health Concern

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