title: The health status and health care utilization of deaf and hard-of-hearing persons.
abstract: OBJECTIVE
  To evaluate whether health habits, self-reported health status, and communication with physicians play a role in the known altered health care utilization patterns of deaf and hard-of-hearing persons.
  
  
  METHODS
  A cross-sectional survey. Respondents were given the choice of completing either a self-administered written survey or an American Sign Language interview-administered survey.
  
  
  METHODS
  Eighty-seven deaf and hard-of-hearing members of various organizations serving this population in southeastern Michigan and 88 hearing patients from a family practice clinic in the same area.
  
  
  RESULTS
  Deaf and hard-of-hearing persons visit physicians more frequently (P = .01), have a lower incidence of ever smoking tobacco (P < .0006) and of alcohol use (P = .04), have more difficulties communicating with physicians (P < .001), have trouble understanding physicians (P < .001), and feel less comfortable with physicians (P < .001). Lower current tobacco use among deaf and hard-of-hearing persons was only seen in persons who were not educated beyond high school. Increased frequency of physician visits for deaf and hard-of-hearing persons was especially noticeable in the group of persons 60 years of age and older. Our finding that use of interpreters is associated with increased utilization and decreased understanding suggests deaf and hard-of-hearing patients presenting with interpreters warrant more focused attention from physicians. Reasons for seeing physicians did not explain the difference in frequency of physician visits between the two groups.
  
  
  CONCLUSIONS
  Deaf and hard-of-hearing persons report a lower subjective health status and higher physician utilization, as well as substantial communication difficulties with physicians. They also report better health-related behaviors, namely less use of tobacco and alcohol. The use of interpreters did not decrease physician utilization or improve the understanding of physicians by these persons. Overall, our results underscore the fact that deaf and hard-of-hearing persons constitute a minority population that experiences considerable difficulties in the patient-physician relationship.
authors.affiliation: Department of Family Practice, University of Michigan Medical School, Ann Arbor.
authors.forename: P
authors.initials: P
authors.lastname: Zazove
authors.forename: L C
authors.initials: LC
authors.lastname: Niemann
authors.forename: D W
authors.initials: DW
authors.lastname: Gorenflo
authors.forename: C
authors.initials: C
authors.lastname: Carmack
authors.forename: D
authors.initials: D
authors.lastname: Mehr
authors.forename: J C
authors.initials: JC
authors.lastname: Coyne
authors.forename: T
authors.initials: T
authors.lastname: Antonucci
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D001294:Attitude to Health; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D003625:Data Collection; D003638:Deafness / Q000150:complications / Q000523:psychology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006311:Hearing Disorders / Q000150:complications / Q000523:psychology; D034381:Hearing Loss / Q000150:complications / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012813:Sign Language; D012907:Smoking; D019966:Substance-Related Disorders