Racial Differences in Discrepancies Between Subjective Ratings and Objective Assessments of Hearing Impairment.

Background and objectives: To better understand racial/ethnic disparities in hearing aid use, we examined racial differences in discrepancies between subjective hearing ratings and objective hearing tests as a potential source of this disparity.

Research design and methods: A cross-sectional assessment was conducted using the data from the Health and Retirement Study (HRS). Our analytic sample included 2,568 participants aged 50 and older: 1,814 non-Hispanic White Americans and 754 non-Hispanic Black Americans. Discordant groups were identified based on self-ratings of hearing abilities (positive vs negative) and objective hearing test results (normal vs hearing loss).

Results: Analysis of HRS data revealed that approximately 73% of participants with objectively measured hearing loss reported positive hearing ratings. False positive hearing rates were found to be 80% among Black older adults and 70% among their White counterparts. Odds for false positive hearing ratings were significantly greater for Black older adults, men, those with less than a high school education, more health conditions and depressive symptoms, and current smoking. Racial differences were maintained after adjustment for these covariates.

Discussion and implications: While cost of hearing aids has been a predominant explanation of low hearing aid use in Black Americans, false positive perceptions of hearing abilities may also play a significant role as a psychosocial mechanism. Future studies examining racial/ethnic differences in possible psychosocial mechanisms for discrepancies between objective and subjective hearing could guide the development and evaluation of culturally appropriate educational interventions.