title: Addressing Hearing Health Care Disparities among Older Adults in a US-Mexico Border Community.
abstract: Hearing loss is associated with cognitive decline and impairment in daily living activities. Access to hearing health care has broad implications for healthy aging of the U.S.
  
  
  METHODS
  This qualitative study investigated factors related to the socio-ecological domains of hearing health in a U.S.-Mexico border community experiencing disparities in access to care. A multidisciplinary research team partnered with community health workers (CHWs) from a Federally Qualified Health Center (FQHC) in designing the study. CHWs conducted interviews with people with hearing loss (n = 20) and focus groups with their family/friends (n = 27) and with members of the community-at-large (n = 47). The research team conducted interviews with FQHC providers and staff (n = 12). Individuals experienced depression, sadness, and social isolation, as well as frustration and even anger regarding communication. Family members experienced negative impacts of deteriorating communication, but expressed few coping strategies. There was general agreement across data sources that hearing loss was not routinely addressed within primary care and assistive hearing technology was generally unaffordable. Community members described stigma related to hearing loss and a need for greater access to hearing health care and broader community education. Findings confirm the causal sequence of hearing impairment on quality of life aggravated by socioeconomic conditions and lack of access to hearing health care. Hearing loss requires a comprehensive and innovative public health response across the socio-ecological framework that includes both individual communication intervention and greater access to hearing health resources. CHWs can be effective in tailoring intervention strategies to community characteristics.
authors: Arizona Prevention Research Center, College of Public Health, University of Arizona , Tucson, AZ , USA.
authors: Maia
authors: M
authors: Ingram
authors: Speech Language and Hearing Sciences, University of Arizona , Tucson, AZ , USA.
authors: Nicole
authors: N
authors: Marrone
authors: Speech Language and Hearing Sciences, University of Arizona , Tucson, AZ , USA.
authors: Daisey Thalia
authors: DT
authors: Sanchez
authors: Community Health Services, Mariposa Community Health Center , Nogales, AZ , USA.
authors: Alicia
authors: A
authors: Sander
authors: Community Health Services, Mariposa Community Health Center , Nogales, AZ , USA.
authors: Cecilia
authors: C
authors: Navarro
authors: Arizona Prevention Research Center, College of Public Health, University of Arizona , Tucson, AZ , USA.
authors: Jill Guernsey
authors: JG
authors: de Zapien
authors: Department of Spanish and Portuguese, University of Arizona , Tucson, AZ , USA.
authors: Sonia
authors: S
authors: Colina
authors: Speech Language and Hearing Sciences, University of Arizona , Tucson, AZ , USA.
authors: Frances
authors: F
authors: Harris
keywords: aging; community health workers; community-based participatory research; health disparities; hearing loss; socio-ecological model