title: Triple difficulties in Japanese women with hearing loss: marriage, smoking, and mental health issues.
abstract: OBJECTIVE
  To examine the consequences of early-onset hearing loss on several social and health measures and any related gender differences in Japanese populations.
  
  
  METHODS
  Data from a 2007 nationally representative cross-sectional household survey of 136,849 men and women aged 20 to 39 years were obtained (prevalence of self-reported hearing loss: 0.74%). We focused particularly on four social and health measures: employment status (employed/unemployed), marital status (married/unmarried), smoking behavior (yes/no), and psychological distress (K6 instrument: ≥ 5 or not). We examined the association of hearing loss for each measure using generalized estimating equations to account for correlated individuals within households.
  
  
  RESULTS
  There was no significant association with employment status (p = 0.447). Men with hearing loss were more likely to be married, whereas women with hearing loss were less likely to be married (p < 0.001 for interaction). Although hearing loss was not associated with a current smoking status in men, women with hearing loss were more likely to be current smokers (p < 0.001 for interaction). Moreover, hearing loss was associated with psychological distress in men and women (both p < 0.001).
  
  
  CONCLUSIONS
  These findings suggest that hearing loss is related to social and health issues in daily life, including a lower likelihood of marriage, more frequent smoking, and poorer mental health, especially in women. These issues may reflect a gap between the actual needs of women with hearing loss and the formal support received as a result of existing public health policies in Japan.
authors: Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan; Research and Support Center on Higher Education for the Hearing and Visually Impaired, Tsukuba University of Technology, Ibaraki, Japan.
authors: Yoko
authors: Y
authors: Kobayashi
authors: Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Nanako
authors: N
authors: Tamiya
authors: Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
authors: Yoko
authors: Y
authors: Moriyama
authors: Yale Institute for Network Science, Yale University, New Haven, Connecticut, United States of America; Department of Sociology, Yale University, New Haven, Connecticut, United States of America.
authors: Akihiro
authors: A
authors: Nishi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D034381:Hearing Loss / Q000150:complications / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008603:Mental Health; D017678:Sex Distribution; D012907:Smoking / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications; D055815:Young Adult
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