The prevalence of hearing loss in the US population is 8.6% and rising. The few studies of health care services utilization and health status have limited scope and sometimes present inconsistent findings. Their results do suggest barriers to health services access and lower health status for people with hearing loss. Part of the difficulty in studying this population is that deaf and hard-of-hearing people are a heterogenous group with various communication needs and sociocultural characteristics. No studies have examined health characteristics data while considering different sociocultural categories of people with hearing loss. We will examine the health services utilization, health status, health knowledge and health behaviors of people with hearing loss. For the purpose of this study, the population of people with hearing loss will be divided to create socioculturally relevant categories. These sociocultural groups can be defined by preferred communication mode. We will estimate preferred communication mode by using severity of bilateral hearing loss and categories of age of onset of hearing loss: prelingual, prevocational and postvocational. The National Health Interview Surveys in 1990 and 1991 included questions related to hearing ability in a Hearing Supplement. Information collected includes whether the hearing loss is bilateral, the hearing loss severity and age of onset. From this information, categories of people with hearing loss will be constructed that reflect sociocultural and linguistic characteristics. Multivariate statistical analyses, adjusted for the complex survey design and potentially confounding factors, will be used to examine health care services utilization, health status, health knowledge and health behaviors of deaf people, categorized by age of onset of hearing loss. The proposed analyses will provide new information relevant to the sociocultural implications of hearing loss as they relate to health care system accessibility. This is particularly important in a system that is increasingly focused on health outcomes. Although the Americans With Disabilities Act may improve health services access for people with hearing loss, it does not guarantee that this will occur in a manner that considers improved health outcomes or health care costs. The results of this study will be valuable in planning efforts to improve health status and health care system accessibility for deaf persons.
