Educational Disparities in Age-Related Hearing Loss and Hearing Aid Use Across Age, Gender, and European Region.

Objectives: Affecting 1 in 5 adults in Europe, hearing loss (HL) is linked to adverse health outcomes, including dementia. We aim to investigate educational inequalities in hearing health in Europe and how these inequalities change with age, gender, and region.

Methods: Utilizing 2004-2020 data from the Harmonized Survey of Health, Ageing, and Retirement in Europe (SHARE), a representative sample of Europeans aged 50 and older, we analyze: (1) age-standardized prevalence of HL and hearing aid (HA) use among eligible individuals and (2) educational inequalities therein using the Relative Index of Inequality across age, gender, and European regions.

Results: The prevalence of self-reported HL increases with age, is greater among men, and is consistently higher among those with lower levels of education. At age 50-64, particularly in Southern and Eastern Europe, low-educated women experience more than 3 times the risk of HL compared to highly educated women. These inequalities diminish as women age. Northern Europe is a front-runner in meeting HA needs. Southern and Eastern Europe lag behind, with less than 2 in 10 individuals eligible for HAs utilizing them.

Discussion: Substantial variations in the educational gradient of hearing health across age, gender, and European regions underscore the importance of targeting specific subpopulations in efforts to mitigate health inequalities. Of particular concern is the regional discrepancy between the prevalence of HL and the use of HAs. The example of Northern Europe suggests that there is unused potential to improve healthy aging in Europe through enhanced access to HAs.