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As printed in Hearing Health, volume 21:1,
Spring 2005
By Mary Sullivan
The 1979 Surgeon General’s Report, “Healthy
People” and “Healthy People 2000: National
Health Promotion and Disease Prevention Objectives”
both established national health objectives and served
as the basis for the development of state and community
plans. For this century, we have a new set of health
objectives for the nation, detailed in “Healthy
People 2010” and coordinated by the U.S. Public
Health Service.
“Healthy People 2010” identifies 28 focus
areas regarding the most significant preventable threats
to public health and calls on both public and private
resources to address these threats. “Healthy People
2010” has established the prevention of vision
and hearing loss and the allocation of significant resources
to improve vision and hearing as priorities for the
nation’s health agenda.
The National Institute on Deafness and Other Communication
Disorders (NIDCD), part of the National Institutes of
Health, is leading the federal effort to help people
improve and protect their hearing with Healthy Hearing
2010, a national initiative targeting prevention, early
detection, treatment and rehabilitation. It challenges
individuals, communities and professionals — all
of us — to take specific steps to ensure healthy
hearing.
A report was recently issued on the progress of meeting
the goals set out in Healthy Hearing 2010, noting the
obstacles to improved hearing and challenging federal
agencies to better collaborate and explore new strategies
and opportunities for progress. The following observations
from the report also serve as a guideline to a hearing
healthy lifestyle in the various stages of life.
Newborn Hearing Screening, Evaluation
and Intervention
Congenital hearing loss must be identified as close
to birth as possible, preferably within the first year
of life. Early identification of deafness is a critical
factor in preventing or ameliorating language delay
in children who are deaf or hard of hearing. Studies
have shown that early intervention can make a significant
difference in a child’s ability to acquire language
at the same rate as her peers or with minimal delay.
About two-thirds of hospitals and birthing centers
perform newborn hearing screening according to the Centers
for Disease Control and Prevention’s (CDC) recommendations.
Of those infants for whom an evaluation is indicated,
56 percent receive this service before three months
of age. Of those infants who are evaluated, 57 percent
are enrolled in appropriate intervention before the
age of six months. Clearly, we have substantial work
ahead to increase these percentages thereby giving every
child with hearing loss the best chance at healthy hearing.
The NIDCD continues to develop new tools to evaluate
and modify intervention programs in newborns.
Prevention and Effective Treatment
of Otitis Media in Children
Infection or inflammation of the middle ear is one of
the most common reasons for visits to physicians by
children and adolescents and the most common cause of
conductive hearing loss in children. More than half
of the children in this country have an episode of otitis
media before their first birthday and 90 percent have
an episode by age five. The good news is that for children
and adolescents age 18 and younger, there has been a
decline in the number of visits to physician’s
offices for otitis media.
More information is needed about the predisposing factors
for otitis media, both environmental and genetic. The
NIDCD supports research on otitis media to improve scientific
understanding and to formulate more effective prevention
strategies. Vaccine development for otitis media is
a high priority.
Hearing Evaluation and Rehabilitation
Although more and more Americans are experiencing a
gradual reduction in hearing during their adult years,
only 29 percent of adults 20 to 69 years of age have
had their hearing tested within the last five years.
Regular hearing testing would likely improve hearing
loss identification and intervention and increase productivity
and quality of life for people with hearing loss. The
American Speech-Language-Hearing Association recommends
adult hearing screening at least every decade until
age 50, with more frequent monitoring after 50 years
of age. Those identified with hearing loss need appropriate
treatment, such as hearing aids, cochlear implants and
assistive devices.
Whereas many young children who are deaf or very hard
of hearing are taking advantage of cochlear implantation,
only a small number of older people with hearing impairment
use listening devices. The problem is particularly prevalent
among those over the age of 70. The NIDCD supports and
conducts a range of studies aimed at improving hearing
aids, cochlear implants and other listening devices.
Prevention of Noise-Induced
Hearing Loss
Approximately 10 million Americans have permanent, irreversible
hearing loss from exposure to loud noise or trauma.
Hearing protection devices such as earplugs or earmuffs
are recommended when people are exposed to high noise
levels whether at work or during leisure or recreational
activities. Wise Ears!® is a noise-induced hearing
loss prevention and education campaign led by the NIDCD
in partnership with the CDC’s National Institute
for Occupational Safety and Health and many other organizations.
This successful education effort for the general public
places special emphasis on children and people in the
workforce.
Reduction of Hearing Health
Disparities
Every person of every age and background is vulnerable
to the ravages of hearing disorders. However, certain
ethnic groups suffer from hearing impairments at a greater
frequency than the majority population. For example,
Hispanic children suffer from higher rates of otitis
media with effusion compared to non-Hispanic white or
black children. Further, healthy hearing information
is not always available to minority individuals and
their families.
The NIDCD devotes numerous resources to making Americans
of all backgrounds aware of proper hearing health and
of available resources for those with impaired hearing.
The NIDCD has an ongoing Hispanic outreach initiative
through participation with various Spanish-language
and Hispanic-interest meetings, exhibit opportunities
and other collaborative efforts.
Finally, the report on Healthy Hearing 2010 identified
these other areas as potentially significant steps to
further progress toward the plan objectives:
- Continue research to improve fitting hearing assistive
devices for infants and very young children
- Conduct studies on persons who have received cochlear
implants to determine why some people benefit more
than others
- Direct additional resources to the identification
and characterization of genes responsible for hereditary
hearing impairment.
A hearing healthy lifestyle is something we must attend
to at birth, in childhood and as young and old adults.
It is a personal responsibility for us to prevent hearing
damage for ourselves and our children, seek recommended
evaluation and, if needed, intervention and treatment.
A hearing healthy lifestyle is also a societal responsibility
that we can address through supporting initiatives like
Healthy Hearing 2010, advocating for relevant legislation
and supporting research on hearing disorders. Healthy
hearing is up to each of us and to all of us.
For more information on Healthy Hearing 2010, visit
the NIDCD Web site at: www.nidcd.nih.gov.
Mary Sullivan is a technical writer
and editor for the National Institute on Deafness and
Other Communication Disorders.
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