Hearing Loss and Discrimination: Evidence of Intersectionality in the All of Us Research Program.

Abstract

Objectives: Hearing loss (HL) has significant implications on social functioning. Here, we study the relationship between HL, race, and these combined categories as risk factors for discrimination in the large national All of Us cohort.

Methods: The National Institutes of Health All of Us dataset was analyzed after including individuals who completed the Everyday Discrimination Survey between November 2021 and January 2022. HL and potential medical confounders were defined per ICD-10 codes or demographics. Multivariable linear regressions analyzing the relationship between HL and discrimination were adjusted for potential confounders, including age, gender, race, ethnicity, other demographic factors, and relevant medical conditions, such as depression and dementia. Additional regressions were conducted to evaluate how combined HL and race categories associated with discrimination risk.

Results: Totally 8,722 individuals ≥18 years old had complete data. The mean age was 65 years (SD = 13.0 years), and 41% were women. Individuals with HL, compared with those without, were more likely to report discrimination in six out of nine questions on the Everyday Discrimination Survey (p < 0.05, with effect sizes ranging from -0.05 to -0.16 on a 6-point scale from 0 = "Almost everyday" to 5 = "Never"). Notably, for four out of those six questions, combined Black race and HL was associated with a risk of discrimination independent from the risk conveyed by race and/or HL individually.

Conclusions: This study offers evidence of HL as a risk factor for self-reported discrimination. Further, this study provides support for an intersectional understanding between discrimination, race, and HL.

Level of evidence: III, Laryngoscope, 2024 Laryngoscope, 2025.