{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T04:09:41Z","timestamp":1793074181205,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Social determinants of health (SDH) are nonmedical, societal factors that influence health. There is limited information on the current relationship between SDH and hearing loss (HL) in the United States. This study aims to compare the odds of HL among US adults by race\/ethnicity, education level, income\u2010to\u2010poverty level ratio, health insurance coverage, and health care access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2015\u20132020 National Health and Nutrition Examination Survey data were analyzed to compare odds ratios (ORs) for HL, defined as pure tone average over 25\u2009dB HL in at least one ear, by SDH categories using sample weights. Adjusted ORs were calculated using logistic regression models controlling for sex, age, race\/ethnicity, education level, income\u2010to\u2010federal\u2010poverty level, health care insurance coverage and access, and loud noise, pesticide, and cigarette exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 6028 participants were included. Non\u2010Hispanic Black participants had half the odds of HL as Non\u2010Hispanic White participants (OR 0.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Lower education level correlated with higher odds of HL: those without a high school diploma had double the odds of HL compared with college graduates or above (OR 2.05, 1.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The income\u2010to\u2010federal\u2010poverty level ratio of 1.3 to less than 2 had higher odds of HL than the 4+ group (OR 1.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Use of multiple health care locations was associated with nearly three times the odds of HL than the group using one location (OR 2.87,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SDH are associated with HL. Further investigation is needed into the mechanism of disparities for targeted prevention and treatment for hearing care equity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      IV\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:2848\u20132856, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31268","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T06:23:56Z","timestamp":1704867836000},"page":"2848-2856","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Social Determinants of Health and Hearing Loss in U.S. Adults"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-0199-7695","authenticated-orcid":false,"given":"Monica","family":"O'Brien","sequence":"first","affiliation":[{"name":"Tufts University School of Medicine  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6992-7547","authenticated-orcid":false,"suffix":"III","given":"David O.","family":"Danis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tufts Medical Center  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Gall","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tufts Medical Center  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey","family":"Woods","sequence":"additional","affiliation":[{"name":"University of Massachusetts Chan School of Medicine  Worcester Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Noonan","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine  Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology Tufts Medical Center  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000001188"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211039490"},{"key":"e_1_2_7_4_1","unstructured":"Social determinants of health. 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