HEARING IMPAIRMENT 

Research Highlights

• National estimate of adult Canadians who experience hearing loss ranges from 3% to 23%.
• There are significant stigmas that lead many Canadians to report that they would avoid wearing a hearing aid at all costs, such as the belief that hearing aids are for senior citizens and the belief that hearing loss results in social alienation.

Current Situation in Guelph-Wellington

• 3.4% of Guelph-Wellington residents report experiencing difficulties with their hearing.
• The cost of hearing aids, technical devices and related services is high especially for seniors and individuals on fixed incomes.
• There are high unemployment and under-employment rates among the deaf community.

What is Hearing Impairment?
Hearing impairment refers to limitation of function as measured by a raised hearing threshold, measured as decibels of hearing loss (dB HL) relative to the hearing of a normal population. Hearing disability refers to the limitation in performing everyday tasks such as understanding speech in the presence of background noise.

Causes of Hearing Loss
There are many causes of hearing loss including genetics, meningitis, ear infections, disease, injury and drugs or medication. Two of the leading causes are hearing loss associated with aging (presbycusis) and prolonged exposure to noise.

Hearing Impairment and Children
Hearing loss present at birth is called congenital. It can be caused by:

• Illness or infection the mother had during pregnancy.
• Medicines taken by the mother during pregnancy.
• Physical abnormality of any part of the ear.
• Hereditary factors - dominant gene only needs to be carried by one parent; recessive gene needs to be carried by both parents.
• Other medical problems (syndromes).

Hearing loss which develops later is called acquired. It can be caused by:

• Difficulty during birth.
• Jaundice.
• Meningitis, scarlet fever, mumps or other illnesses associated with high fever.
• Neurodegenerative disorders.
• Medications which are toxic to the inner ear.
• Head injury or trauma to the inner ear.
• Repeated or constant ear infections.

The drive for a universal newborn hearing screening program in Canada is an on-going initiative by some of Canada's leading specialists and audiologists. Presently, the average age of identification is 2 ½ to 3 years of age, which is well past the critical time when children are rapidly developing language, speech and social skills. Early diagnosis and intervention can profoundly impact a child's success, both in the classroom and on the playground.

• Children, including newborns, can be screened for hearing loss at any age - the earlier the better.
• Babies as young as three months can be fitted with hearing aids.
• When babies are diagnosed and treated for hearing loss by six months, their language levels are higher and they show no evidence of the developmental delays seen in children who are diagnosed after six months.

Hearing Impairment and Seniors
Hearing loss is a common and potentially disabling problem in older individuals and is often regarded as an inevitable consequence of normal aging. But hearing loss is insidious; it may develop slowly and gradually so that the individual may not even be aware of any impairment, or the consequences of the impairment. Hearing loss may impair physical and social function, and is associated with cognitive deficits, mood disturbances and behavioural disorders. Hearing aids, however, can significantly improve the quality of life. Individuals with hearing loss who do not use hearing aids report higher rates of depression, sadness, anxiety, and paranoia¹. Furthermore, they become less socially active and experience greater emotional insecurity.

Incidence and Prevalence ²
According to national data from the 2003 Canadian Community Health Survey (CCHS), about 3% of the Canadian household population aged 12 or older had some type of difficulty with their hearing. An Awareness Study conducted by the Canadian Hearing Society (2001), however, revealed a much higher percentage. It reported that 23% of adult Canadians have some degree of hearing loss. Of these, one-quarter is under 40, and almost half are between 40 - 60 years old.
 
An estimated 135,000 Ontarians between the ages of 16-65 are deaf, deafened or hard-of-hearing. Of this number, 36% have difficulty hearing in a group setting, 39% have difficulty hearing one-to-one, and 25% are completely unable to hear³.
 
It is estimated that approximately 3.4% of Guelph and Wellington County residents have some type of difficulty with their hearing (2001)⁴.
 
Because hearing problems tend to increase with age, seniors are disproportionately affected. Although seniors accounted for just 14% of the overall population surveyed by the CCHS, they represented 55% of people with hearing problems. About 11% of the population aged 65 and older (402,000 seniors) had a hearing problem; 5% of those aged 65-69, and 23% of those aged 80 and older.

Decline in Hearing Problems
From 1994/95 to 2003, the proportion of seniors with hearing problems declined from 18% to 11%. The decrease was evident in all senior age groups, both sexes.

Community Supports & Services (Non-Medical)
The Canadian Hearing Society provides two services: Information Services & Community Development program which offers information and education on hearing loss and deafness though presentations, displays, community consultations and workshops for seniors, employers and the public; and a Hearing Care Counselling Program which provides communication and hearing support services to individuals 55 years of age and older with an acquired hearing loss, to enable them to carry out daily living activities independently and with reduced communication difficulties.
 
The Hearing Improvement Committee of Guelph is an organization run by volunteers to assist those with hearing loss and to help cope with associated life changes. It also disseminates information, promotes hearing help courses and hearing accessibility in public places.
 
Of the above mentioned services, the United Way of Guelph & Wellington supports the Canadian Hearing Society and its two programs; Information Services & Community Development and Hearing Care Counselling Program.

What are the Social Service Issues in Guelph-Wellington? 
 
Community Awareness & Education
Hearing impairments not only affect the ability to hear but also the ability to communicate effectively, resulting in other restrictions. Regardless of the severity of the hearing impairment, hearing problems can place considerable strain on interpersonal relationships, as a hearing disorder usually makes communication more difficult and affects social skills. Hearing impaired people will often then withdraw from social situations, as they do not want to be a burden to the person to whom they are talking. According to the Canadian Hearing Society Survey (2001), 41% of people with hearing loss find communication so difficult that they typically withdraw. Acceptance of hearing loss and overcoming communication barriers, therefore, is imperative in order to avoid social isolation and live with increased independence.
 
In addition, for many there is the fear of being stigmatized, involving anxiety about their ability to carry out a job, loss of potential career advancement, and fear of being viewed as “different” and/or “deficient”. Furthermore, there are significant stigmas that lead many Canadians to report that they would avoid wearing a hearing aid at all costs, such as the belief that hearing aids are for senior citizens and hearing loss results in social alienation. According to the Canadian Hearing Society Survey (2001), one in six hearing Canadians say they would rather live with some hearing loss than wear a hearing aid. This number jumps to one in five among those who claim to have personally experienced hearing loss.
 
Financial Burden of Assessment, Hearing Aids and Technical Devices
The needs of hearing impaired individuals have been greatly affected by the delisting of audiology services from OHIP ⁵. Hearing aid evaluations and fittings are no longer covered under any circumstances, resulting in a large number of seniors and individuals on fixed incomes without the means to pay for this expense. Currently, the Canadian Hearing Society attempts to work with patients to find third party funding to cover the cost of testing and hearing aids. The cost of hearing aids can vary widely depending on an individual’s needs, choice of technology, choice of style, and choice of vendor.
 
Employment Opportunities for those with a Hearing Disability
Although there are no clear estimates of the rate of unemployment among hard of hearing people in Canada, one study conducted estimated the unemployment rate to be an astonishing 38% among deaf people. Furthermore this same study reported that among the deaf people who are employed, almost two-thirds are under-employed⁶.
 
Likewise, the Literacy Survey of Ontario’s Deaf and Hard of Hearing Adults (1998) reported that deaf, deafened and hard of hearing individuals are less likely to be employed and also to earn less than other Ontarians ⁷ . The survey also showed high unemployment and under-employment rates, low rates of full-time employment and low rates of participation in post-secondary education and skill training programs.
 
Currently, large numbers of deaf, deafened and hard of hearing youth are receiving income maintenance. Unemployment of young adults appears to be increasing. A study showed that 24% of deaf youth were unemployed 3-4 years after high school, and that 40% of deaf youth with additional disabilities were unemployed ⁸ .

1. Health Reports, Vol.16, No.4, June 2005.
2. Accurate statistics on hearing loss are very difficult to obtain. Most of the research and statistics gathering rely on self-identification and an inconsistent use of terminology and definitions. It is very common for people to deny their hearing loss. In addition, many hard of hearing people who have adapted well to their hearing loss, their hearing aids and other assistive listening devices may report that they have no difficulties hearing and are therefore excluded from the statistics.
3. Ontario Ministry of Education and Training (1998). Literacy Profile of Ontario’s Deaf and Hard of Hearing Adults. Toronto, Ontario: Ministry of Education and Training – Literacy and Basic Skills Section, Workplace Preparation Branch.
4. Statistics Canada (2001). Canadian Community Health Survey – Cycle 1.1. Ottawa, Ontario: Statistics Canada.
5. The Canadian Hearing Society (2001). Annual Report 2001-2002. Retrieved June 13, 2005, from http://www.chs.ca/pdf/AGR01-02Eng.pdf.
6. The Canadian Hearing Society (2005). Submission to the Standing Committee on Social Policy With Respect to Bill 118: Accessibility for Ontarians with Disabilities Act, 2004. Retrieved June 14, 2005, from http://www.chs.ca.pdf/Bill_118_Submission.pdf.
   
7. Ontario Ministry of Education and Training (1998). Literacy Profile of Ontario’s Deaf and Hard of Hearing Adults. Toronto, Ontario: Ministry of Education and Training – Literacy and Basic Skills Section, Workplace Preparation Branch.
8. Ibid.