title: Socioeconomic disparities for hearing-impaired children in the United States.
abstract: OBJECTIVE
  This study aims to evaluate disparities in socioeconomic status and healthcare utilization in hearing-impaired children using a nationally representative sample.
  
  
  METHODS
  Cross-sectional analysis of stacked data from the 1997 to 2003 National Health Interview Survey, a voluntary U.S. household survey of the National Center for Health Statistics.
  
  
  METHODS
  Children were grouped according to three levels of hearing ability based on parental response to perceived hearing status. χ(2) and analysis of variance (ANOVA) models tested the association of individual sociodemographic variables with hearing status. Multivariate regression analyses examined the association of hearing impairment with family income, poverty status, and utilization of routine and specialty health services.
  
  
  RESULTS
  The total sample consisted of 76,012 children, of whom 2.6% had some hearing loss and 0.43% had marked hearing loss. Families of hearing-impaired children were more likely to report poorer health status, have Medicaid, live in single-mother households, and live below the poverty level (P < .01). After adjusting for confounders, children with mild and marked hearing impairment were less likely to afford prescription medications (odds ratio [OR] = 1.89, 95% confidence interval [CI], 1.44-2.48 [mild]; OR = 2.72, 95% CI, 1.73-4.29 [marked]) and less likely to have access to mental health services (OR = 3.26, 95% CI, 2.41-4.69 [mild]; OR = 2.62, 95% CI, 1.34-5.12 [marked]) or dental services (OR = 1.65, 95% CI, 1.36-2.02 [mild]; OR = 1.62, 95% CI, 1.09-2.41 [marked]). No difference was identified for access to routine/sick health services.
  
  
  CONCLUSIONS
  Compared with families of children without hearing loss, families of hearing-impaired children live closer to the poverty level and utilize some medical services with less frequency. Further identification of causal relationships between familial socioeconomic status and childhood hearing loss may help direct policy initiatives designed to mitigate healthcare disparities and improve access to services for hearing-impaired children.
authors: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. erudnic2@jhmi.edu
authors: Emily F
authors: EF
authors: Boss
authors: John K
authors: JK
authors: Niparko
authors: Darrell J
authors: DJ
authors: Gaskin
authors: Kimberly L
authors: KL
authors: Levinson
mesh_terms: D001309:Auditory Threshold; D002648:Child; D003157:Community Pharmacy Services / Q000191:economics / Q000706:statistics & numerical data; D003752:Dental Health Services / Q000191:economics / Q000706:statistics & numerical data; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D019986:Persons with Hearing Disabilities / Q000706:statistics & numerical data*; D011203:Poverty / Q000191:economics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data