title: Hearing Impairment Prevalence and Associated Risk Factors in the Hispanic Community Health Study/Study of Latinos.
abstract: OBJECTIVE
  Hearing impairment is common in adults, but few studies have addressed it in the US Hispanic/Latino population.
  
  
  OBJECTIVE
  To determine the prevalence of hearing impairment among US Hispanic/Latino adults of diverse backgrounds and determine associations with potential risk factors.
  
  
  METHODS
  The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a population-based sample of Hispanics/Latinos in four US communities (Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California). Examinations were conducted from 2008 through 2011. The HCHS/SOL examined 16,415 self-identified Hispanic/Latino persons aged 18 to 74 years recruited from randomly selected households using a stratified 2-stage area probability sample design based on census block groups and households within block groups.
  
  
  METHODS
  Hearing thresholds were measured by pure-tone audiometry. Hearing impairment was defined as a pure-tone average (PTA) of thresholds at 0.5, 1, 2, and 4 kHz greater than 25 dB hearing level. Bilateral hearing impairment required a PTA greater than 25 dB hearing level in both ears. Multivariable analyses included adjustments for sociodemographic and lifestyle variables, body mass index, and medical conditions.
  
  
  RESULTS
  The prevalence of hearing impairment was 15.06% (SE, 0.44%) overall, and 8.24% (SE, 0.33%) had bilateral hearing impairment. The prevalence of hearing impairment was higher among people 45 years and older, ranging by Hispanic/Latino background from 29.35% to 41.20% among men and 17.89% to 32.11% among women. The multivariable-adjusted odds of hearing impairment was greater for participants of Puerto Rican background compared with Mexican background (odds ratio [OR], 1.57 [95% CI, 1.10-2.25]). The odds of hearing impairment were lower with more education (OR, 0.71 [95% CI, 0.59-0.86] for at least high school) and higher income (OR, 0.58 [95% CI, 0.36-0.92] for >$75,000 vs ≤$10,000). Noise exposure (OR, 1.35 [95% CI, 1.07-1.70]), diabetes (OR, 1.57 [95% CI, 1.27-1.94]), and prediabetes (OR, 1.37 [95% CI, 1.12-1.67]) were associated with hearing impairment.
  
  
  CONCLUSIONS
  Hearing impairment is a common problem for older Hispanics/Latinos in these communities and is associated with socioeconomic factors, noise exposure, and abnormal glucose metabolism. Longitudinal studies are needed to determine whether these factors are involved in the etiology of hearing impairment and to identify ways to prevent or delay age-related changes in hearing.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison2Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Cruickshanks
authors.affiliation: Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois.
authors.forename: Sumitrajit
authors.initials: S
authors.lastname: Dhar
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, University Hospital for Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dinces
authors.affiliation: Mailman Center for Child Development, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Fifer
authors.affiliation: Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill.
authors.forename: Franklyn
authors.initials: F
authors.lastname: Gonzalez
authors.affiliation: Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
authors.affiliation: Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Hoffman
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
authors.affiliation: College of Health and Human Services, San Diego State University, San Diego, California10School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, California.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Newhoff
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, University Hospital for Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Laura
authors.initials: L
authors.lastname: Tocci
authors.affiliation: School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, California.
authors.forename: Peter
authors.initials: P
authors.lastname: Torre
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
authors.forename: Ted S
authors.initials: TS
authors.lastname: Tweed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002489:Central America / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008800:Mexico / Q000208:ethnology; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013020:South America / Q000208:ethnology; D014504:Urban Health / Q000208:ethnology*; D014900:West Indies / Q000208:ethnology; D055815:Young Adult