title: Hearing-Related Health Among Adult American Indians From a Pacific Northwest Tribe.
abstract: BACKGROUND
  Hearing loss and tinnitus are common in most populations, although few data have addressed hearing-related health among tribal members and the need for public health interventions.
  
  
  METHODS
  This cross-sectional study examined prevalence and risk factors for hearing loss and tinnitus among 217 adults in a Pacific Northwest tribe. Frequency measures were conducted for difficulty hearing certain sounds and hearing aid use. In 2006, risk factors were examined for two outcomes-hearing loss and tinnitus-with analysis conducted in the same year.
  
  
  RESULTS
  Although self-reported hearing loss was more common in men (24%) than women (13%), a larger percentage of women compared with men reported difficulty hearing certain sounds. Only 8% of study participants reported hearing aid use. After age adjustment, significant noise exposure was associated with hearing loss (OR=8.30, 95% CI=1.84, 37.52). The overall prevalence of tinnitus was 33% (similar in men and women). After adjusting for age, the odds of tinnitus in individuals with more than four ear infections was 4.77 (95% CI=1.89, 12.02) times the odds in those who never had an ear infection. Tinnitus was also associated with significant noise exposure (OR=2.24, 95% CI=1.28, 6.73) even after age adjustment.
  
  
  CONCLUSIONS
  Increasing age and significant noise exposure were associated with hearing loss in this tribe. Tinnitus was associated with significant noise exposure and history of otitis media, even after age adjustment. Public health efforts are needed to improve hearing-related health in this tribe through messages about noise exposure and use of hearing protection.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Kapuaolaokalaniakea
authors.initials: K
authors.lastname: Gellert
authors.affiliation: Center for Healthy Communities, School of Public Health, Oregon Health and Science University, Portland, Oregon; Department of Otolaryngology, National University of Singapore, Singapore.
authors.forename: William Hal
authors.initials: WH
authors.lastname: Martin
authors.affiliation: Center for Healthy Communities, School of Public Health, Oregon Health and Science University, Portland, Oregon.
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Lapidus
authors.affiliation: Northwest Tribe Health and Policy, Suquamish, Washington.
authors.forename: Leslie
authors.initials: L
authors.lastname: Wosnig
authors.affiliation: Center for Healthy Communities, School of Public Health, Oregon Health and Science University, Portland, Oregon. Electronic address: beckert@ohsu.edu.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Becker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D014012:Tinnitus / Q000453:epidemiology*; D055815:Young Adult