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Hearing Day 2024: Changing mindsets: let’s make ear and hearing care a reality for all!

Key messages:

Globally, over 80% of ear and hearing care needs remain unmet.
Unaddressed hearing loss poses an annual cost of nearly US$1 trillion globally.
Deeply ingrained societal misperceptions and stigmatizing mindsets are key factors that limit efforts for preventing and addressing hearing loss.
Changing mindsets related to ear and hearing care is crucial to improving access and mitigating the cost of unaddressed hearing loss.

World Hearing Day 2024 is observed with the following objectives:

Counter the common misperceptions and stigmatizing mindsets related to ear and hearing problems in communities and among health care providers.
Provide accurate and evidence-based information to change public perceptions of hearing loss.
Call on countries and civil society to address misperceptions and stigmatizing mindsets related to hearing loss, as a crucial step towards ensuring equitable access to ear and hearing care.

Key facts

By 2050, nearly 2.5 billion people are projected to have some degree of hearing loss, and at least 700 million will require hearing rehabilitation.
Over 1 billion young adults are at risk of permanent, avoidable hearing loss due to unsafe listening practices.
An annual additional investment of less than US$ 1.40 per person is needed to scale up ear and hearing care services globally.
Over a 10-year period, this promises a return of nearly US$ 16 for every US dollar invested.

Overview

Over 5% of the world’s population – or 430 million people – require rehabilitation to address their disabling hearing loss (including 34 million children). It is estimated that by 2050 over 700 million people – or 1 in every 10 people – will have disabling hearing loss.

Disabling hearing loss refers to hearing loss greater than 35 decibels (dB) in the better hearing ear. Nearly 80% of people with disabling hearing loss live in low- and middle-income countries. The prevalence of hearing loss increases with age, among those older than 60 years, over 25% are affected by disabling hearing loss.

Hearing loss and deafness

A person who is not able to hear as well as someone with normal hearing – hearing thresholds of 20 dB or better in both ears – is said to have hearing loss. Hearing loss may be mild, moderate, severe or profound. It can affect one ear or both ears and leads to difficulty in hearing conversational speech or loud sounds.

Hard of hearing refers to people with hearing loss ranging from mild to severe. People who are hard of hearing usually communicate through spoken language and can benefit from hearing aids, cochlear implants, and other assistive devices as well as captioning.

Deaf people mostly have profound hearing loss, which implies very little or no hearing. They often use sign language for communication.

Causes of hearing loss and deafness

Although these factors can be encountered at different periods across the life span, individuals are most susceptible to their effects during critical periods in life.

Prenatal period

genetic factors including hereditary and non-hereditary hearing loss
intrauterine infections – such as rubella and cytomegalovirus infection.

Perinatal period

birth asphyxia (a lack of oxygen at the time of birth
hyperbilirubinemia (severe jaundice in the neonatal period)
low-birth weight
other perinatal morbidities and their management.

Childhood and adolescence

chronic ear infections (chronic suppurative otitis media)
collection of fluid in the ear (chronic nonsuppurative otitis media)
meningitis and other infections.

Adulthood and older age

chronic diseases
smoking
otosclerosis
age-related sensorineural degeneration
sudden sensorineural hearing loss.

Factors across the life span

cerumen impaction (impacted ear wax)
trauma to the ear or head
loud noise/loud sounds
ototoxic medicines
work related ototoxic chemicals
nutritional deficiencies
viral infections and other ear conditions
delayed onset or progressive genetic hearing loss.

The impact of unaddressed hearing loss

When unaddressed, hearing loss impacts many aspects of life at individual level:

communication and speech;
cognition;
social isolation, loneliness and stigma;
impact on society and economy;effects on years lived with disability (YDLs) and disability adjusted life years (DALYs); and
education and employment: In developing countries, children with hearing loss and deafness often do not receive schooling. Adults with hearing loss also have a much higher unemployment rate. Among those who are employed, a higher percentage of people with hearing loss are in the lower grades of employment compared with the general workforce.

WHO estimates that unaddressed hearing loss poses an annual global cost of US$ 980 billion. This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity and societal costs. Of these costs, 57% are attributed to low- and middle-income countries.

Prevention

Many of the causes that lead to hearing loss can be avoided through public health strategies and clinical interventions implemented across the life course.

Prevention of hearing loss is essential throughout the life course, from prenatal and perinatal periods to older age. In children, nearly 60% of hearing loss is due to avoidable causes that can be prevented through implementation of public health measures. Likewise, most common causes of hearing loss in adults, such as exposure to loud sounds and ototoxic medicines, are preventable.

Effective strategies for reducing hearing loss at different stages of the life course include:

immunization;
good maternal and childcare practices;
genetic counselling;
identification and management of common ear conditions;
occupational hearing conservation programmes for noise and chemical exposure;
safe listening strategies for the reduction of exposure to loud sounds in recreational settings; and
rational use of medicines to prevent ototoxic hearing loss.

Identification and management

Early identification of hearing loss and ear diseases is key to effective management.

This requires systematic screening for detection of hearing loss and related ear diseases in those who are most at risk. This includes:

newborn babies and infants
pre-school and school-age children
people exposed to noise or chemicals at work
people receiving ototoxic medicines
older adults.

Hearing assessment and ear examination can be conducted in clinical and community settings. Tools such as the hearWHO app and other technology-based solutions make it possible to screen for ear diseases and hearing loss with limited training and resources.

Once hearing loss is identified, it is essential that it is addressed as early as possible and in an appropriate manner, to mitigate any adverse impact.

Rehabilitation for hearing loss

Rehabilitation helps people with hearing loss to function at their optimum, which means they can be as independent as possible in everyday activities. Specifically, rehabilitation helps them to participate in education, work, recreation and meaningful roles, e.g. in their families or communities–throughout their lives. Interventions for rehabilitation for people with hearing loss include:

the provision of, and training in the use of, hearing technologies (e.g. hearing aids, cochlear implants and middle ear implants);
speech and language therapy to enhance perceptive skills and develop communication and linguistic abilities; training in the use of sign language and other means of sensory substitution (e.g. speech reading, use of print on palm, Tadoma, signed communication);
the provision of hearing assistive technology, and services (e.g. frequency modulation and loop systems, alerting devices, telecommunication devices, captioning services and sign language interpretation); and
counselling, training and support to enhance engagement in education, work and community life.

Why is it important to be deaf or hard of hearing friendly?

Being deaf or hard of hearing friendly is crucial to fostering inclusivity and ensuring effective communication with individuals who are deaf or hard of hearing. It promotes a supportive environment that allows everyone to participate fully in social activities.

Nearly 20% of people experience some degree of hearing loss and this percentage is increasing. Hence it is likely that we will need to communicate with people who are deaf or hard of hearing in our daily life. Being aware of good communication strategies for persons who are deaf or hard of hearing will allow us to be better communicators with everyone.

As a teacher, how do I support a child who is deaf or hard of hearing in the classroom?

- Ask children what they need as reasonable accommodations from you, the students, and the school staff and be an ally.

- Seat the child in front of the class, when possible and with child’s consent, and face the child directly while speaking.

- Support children who use hearing aids or implants by learning how to troubleshoot common problems, like changing batteries.

- Encourage children to let you know when they are not hearing others and need them to repeat themselves.

- Encourage other children in the class to communicate accordingly such as learning the child’s national sign language or using visual communication.

- Use hearing induction loop and frequency modulation (FM) systems as these can ensure smoother communication for children using hearing aids or implants.

- Teach children to self-advocate for their needs at home and at school. For example, encourage children to inform their teacher or parents when the hearing aid stops working.

- Encourage parents to disclose their child’s disability and not to hide it.

- Include the child in all activities and encourage other children to do the same.

- Facilitate the encounters between the child and other peers and adult role models who are also deaf or hard of hearing.

Look into whether the child has hearing loss if a child is not performing well in class by encouraging parents to get the child’s hearing checked.

How can society include people who are deaf or hard of hearing in various activities?

Through:

- ensuring accessible communication: written information, subtitles or captions, professional national sign language interpreters, will facilitate access to communication, learning and using the national sign language; and

facilitating the use of assistive devices such as hearing aids or implants, FM, infrared and hardwired systems, and hearing induction loops.

How can public spaces be made deaf and hard of hearing friendly?

- Installation of visual alerts: Incorporate visual alerts for important announcements, such as flashing lights or scrolling text, to supplement auditory notifications.

- Provision of hearing induction loop systems: Install hearing loop systems that transmit audio directly to hearing aids, enhancing sound quality for individuals who are deaf or hard of hearing.

Training of staff on communication techniques: Educate staff members on effective communication strategies and the importance of accommodating individuals who are deaf or hard of hearing.

How can employers support people who are deaf or hard of hearing in the workplace?

Employers can support staff who are deaf or hard of hearing by:

- making them aware of reasonable accommodation available to them;

- ensuring all meetings are made accessible for people who are deaf or hard of hearing; for example, holding them in well-lit spaces with clear visuals, providing captions or professional national sign language interpreters, and following up with written summaries;

- making virtual meetings accessible by using good audio equipment for clear audibility, providing professional national sign language interpreters, providing the possibility to multipin, and mandating that participants speak with their cameras on to facilitate lip reading or interpretation;

- fostering an environment where colleagues feel comfortable discussing their hearing/visual needs; and

allowing for flexible work arrangements or breaks to manage appointments related to hearing health.

How can I be an advocate for hearing loss prevention and hearing care?

Be an advocate for hearing loss prevention and hearing care by:

- consulting persons who are deaf and hard of hearing or their representative organizations on what you can do to support them and be their ally;

- participating in awareness campaigns that raise awareness about hearing loss, deafness and hard of hearing, its challenges, and its solutions;

- advocating with businesses and public spaces to invest in accessibility features, such as captioning, hearing loops, sign language translations and visual alerts;

- disseminating information about people who are deaf and hard of hearing, their communication needs, and how individuals and communities can become deaf and hard of hearing friendly;