{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T07:52:27Z","timestamp":1777189947162,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate potential disparities in hearing aid use among urban and rural populations with hearing loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used pooled data from the 2017 and 2018 rounds of the Medicare Current Beneficiary Survey (MCBS). Our analytic sample was restricted to 8107 participants with hearing loss (those who reported little to a lot of trouble hearing) and with a full set of covariates. Multivariate logistic regression models for the probability of hearing aid use were estimated using a participant's place of residence (rural\/urban) and household income relative to the Federal Poverty Level (low and middle income \u2264\u2009200% of Federal Poverty Level (FPL); high income &gt;\u2009200% FPL) as main exposures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In models using place of residence as the main exposure, we found no statistically significant difference in hearing aid use between rural and urban populations. In models combining place of residence with income, we found that respondents in the rural high\u2010income group were at the highest odds for hearing aid use (odds ratio (OR): 1.99, 95% confidence interval (CI): 1.52\u20132.59) when compared to the rural low and middle\u2010income group and, similarly, for the urban high\u2010income (OR: 1.57, 95% CI: 1.26\u20131.96) and urban low and middle\u2010income groups (OR: 1.31, 95% CI: 1.02\u20131.69).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There are potential interactions of metro status and income regarding hearing aid use that are more pronounced in rural populations. This might allow policymakers to target interventions for hearing loss to rural and low\u2010income populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.70125","type":"journal-article","created":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T10:59:50Z","timestamp":1742727590000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Disparities in Hearing Aid Use Among Those With Hearing Loss in Rural and Urban Settings"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3686-0290","authenticated-orcid":false,"given":"Paul","family":"Johnson","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery University of Washington  Seattle Washington USA"},{"name":"Wyoming Department of Health Division of Healthcare Financing  Cheyenne Wyoming USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel Garcia","family":"Morales","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Johns Hopkins University  Baltimore Maryland USA"},{"name":"Cochlear Center for Hearing and Public Health Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery NYU Grossman School of Medicine  New York New York USA"},{"name":"Optimal Aging Institute NYU Langone Health  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-019-00656-3"},{"key":"e_1_2_8_3_1","volume-title":"Global Costs of Unaddressed Hearing Loss and Cost\u2010Effectiveness of Interventions","author":"World Health Organization","year":"2017"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941212101201"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1044\/2018_JSLHR-H-18-0077"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.362"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820910377"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.0734"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41514-024-00136-6"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010113\u20103\u2010188"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.1408"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.4081\/audiores.2011.e25"},{"key":"e_1_2_8_13_1","unstructured":"C.Holm \u201cDoes Medicare or Insurance Cover Hearing Aids in 2024? NCOA Adviser \u201daccessed July 10 2024 https:\/\/www.ncoa.org\/adviser\/hearing\u2010aids\/hearing\u2010aids\u2010insurance\u2010coverage\/."},{"key":"e_1_2_8_14_1","unstructured":"Hearing & Balance Exams \u201cMedicare.gov \u201daccessed July 10 2024 https:\/\/www.medicare.gov\/coverage\/hearing\u2010balance\u2010exams."},{"key":"e_1_2_8_15_1","unstructured":"N.Ochieng \u201cMedicare Advantage in 2023: Enrollment Update and Key Trends \u201d2023accessed July 10 2024 https:\/\/www.kff.org\/medicare\/issue\u2010brief\/medicare\u2010advantage\u2010in\u20102023\u2010enrollment\u2010update\u2010and\u2010key\u2010trends\/."},{"issue":"4","key":"e_1_2_8_16_1","first-page":"e38302","article-title":"The Hearing Aid Effect in the 2020s: Where Do we Stand?","volume":"15","author":"Sindi A.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0898264315585505"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26490"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.5682"},{"key":"e_1_2_8_20_1","first-page":"1","article-title":"Trends in Death Rates in Urban and Rural Areas: United States, 1999\u20102019","volume":"417","author":"Curtin S. C.","year":"2021","journal-title":"NCHS Data Brief"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.19.9.3"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.14.1522"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1044\/2021_AJA-20-00196"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001197"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.01.015"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/14992027.2018.1461262"},{"issue":"3","key":"e_1_2_8_27_1","first-page":"208","article-title":"A Framework for the Study of Access to Medical Care","volume":"9","author":"Aday L. A.","year":"1974","journal-title":"Health Services Research"},{"key":"e_1_2_8_28_1","unstructured":"Center for Devices and Radiological Health \u201cOTC Hearing Aids: What You Should Know. U.S. Food and Drug Administration \u201daccessed July 10 2024 https:\/\/www.fda.gov\/medical\u2010devices\/hearing\u2010aids\/otc\u2010hearing\u2010aids\u2010what\u2010you\u2010should\u2010know."},{"key":"e_1_2_8_29_1","unstructured":"C.Whelan \u201cThe Cost of Hearing Aids: What You Need to Know. Healthline \u201d2023 accessed July 10 2024 https:\/\/www.healthline.com\/health\/cost\u2010of\u2010hearing\u2010aids."},{"key":"e_1_2_8_30_1","unstructured":"State Funding Resources for Audiology and Hearing Aids \u201cAmerican Speech\u2010Language\u2010Hearing Association \u201daccessed July 10 2024 http:\/\/www.asha.org\/public\/coverage\/p3audfundingresources\/."},{"key":"e_1_2_8_31_1","article-title":"Wyoming Governor Signs Bill to Create Adult Hearing Aid Program","author":"Lundin A.","year":"2024","journal-title":"Hearing Review"},{"key":"e_1_2_8_32_1","article-title":"Loud and Clear: Improving Access to Hearing Care in Rural America","author":"Mead A.","year":"2024","journal-title":"Rural Monitor"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T07:45:16Z","timestamp":1746776716000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/lio2.70125"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70125","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,21]]},"assertion":[{"value":"2025-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70125"}}