Sex- and Race-Specific Prevalence of Hearing Loss Across the Adult Lifespan and Associated Factors

Current research lacks detail on sex and race differences in the prevalence of hearing loss, including on the degree of hearing loss across the adult lifespan and whether associated risk factors for hearing loss may vary across sex and race groups. To evaluate the prevalence of hearing loss across the adult lifespan and associated factors and differences across sex-specific and race-specific groups. This study was conducted in the ongoing community-based Medical University of South Carolina Longitudinal Cohort Study of Age-Related Hearing Loss in Charleston, South Carolina (1988 to present, with the sample based in Charleston, South Carolina, and surrounding area). Data were analyzed between May and October 2024. Demographic factors included age, self-reported sex and race, and socioeconomic position, determined by education and occupation. Self-reported hearing-related and health-related factors included a history of noise exposure, diabetes, obesity (defined as a body mass index greater than 30; calculated as weight in kilograms divided by height in meters squared), cardiovascular conditions, smoking pack-years, and number of comorbid conditions. Hearing loss was defined as a worse-ear pure-tone average of thresholds at frequencies 0.5, 1.0, 2.0, and 4.0 kHz greater than 25 dB hearing level. Age-adjusted and multivariable logistic regression models were used to determine factors associated with hearing loss in the entire sample and across sex and race groups separately. Of 1787 included participants, 1013 (56.7%) were female, 322 (18.0%) were Black, 1439 (80.5%) were White, and 26 (1.5%) were another race (including American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, or another race), and the mean (SD) age was 61.3 (16.4) years. The prevalence of hearing loss was 46.2% (825 of 1787) and was highest among White male and female individuals (male: 396 of 652 [60.7%]; female: 326 of 787 [42.1%]) and lower among Black male and female individuals (male: 38 of 113 [33.6%]; female: 61 of 209 [29.2%]). Prevalence increased with age in the entire sample and for all sex and race groups. In a multivariable model, older age, male sex, lower socioeconomic proxy, and noise exposure were associated with higher odds of hearing loss and Black race was associated with lower odds of hearing loss. The prevalence and degree of hearing loss and some associated factors differed across sex and race groups. Hearing loss is an important public health concern that could be addressed through tailored interventions to reduce its risk across populations.