Hearing Aids: Here, There, and Everywhere

Jun 15, 2021 | Global Hearing Health, House Institute Foundation, Uncategorized

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By Erin O’Donnell, Associate Director of Education and Global Health


466 million is a number that is emerging everywhere, slapped onto hearing-related websites, and thrown into urgent policy briefs. This is the estimated number of people living with disabling hearing loss, and it represents 6.1% of the world’s population. By 2050, the prevalence is projected to increase to over 900 million worldwide. That is 1 in every 10 people.

Hearing loss is the most common sensory disability. It disproportionately affects people in low- to middle-income countries (LMICs), with nearly 80% of severe to profound hearing loss affecting individuals in these regions. While 94% of people living with hearing loss can be helped with hearing aids, the World Health Organization (WHO) estimates that only 3% of the need in LMICs is met, constituting a global hearing crisis.

The reasons for this discrepancy are numerous. The most obvious reason is that hearing aids are

unaffordable given their high cost relative to income. Consider an annual income of US $2,250—the GDP per capita in Nigeria. The most basic hearing aids, let alone a year-long supply of hearing aid batteries, are largely unattainable for the average person.

Even with initial access and fittings, routine and reliable follow-up care are not always possible. Many healthcare delivery systems in LMICs face significant challenges from resource and personnel shortages to disruptive environmental and sociopolitical factors. One growing approach is to train community health workers and medical professionals at the primary care level to provide essential audiological screening and care, which is administered at a secondary level in countries like the United States. This less restrictive model may help to increase access to hearing aid fittings, education around their use and maintenance, and rehabilitative services. By incorporating hearing health into routine care, this model also helps raise public awareness about hearing loss and its solutions which is essential for the demand and uptake of services, especially in areas where there is little pre-existing knowledge around hearing health.

The global hearing aid market is dominated by European and North American manufacturers whose primary consumer base has traditionally been relatively affluent, with key selling points tailored to a tech-savvy lifestyle. While many advanced features provide excellent rehabilitation, they are not necessarily supportive nor practical for patients in LMICs. Many manufacturers have large philanthropic initiatives and are shifting focus to incorporate new considerations. Innovations that allow the hearing aid to better resist heat, humidity, or dusty environments, that are solar-powered or function on a readily available power source such as watch batteries, or that can be programmed with open-source software, are a few examples of features that may be more adapted to the actual needs of some populations. The WHO has produced a document recommending evidence-based design features and functions that may offer the greatest benefit in low-resource settings. The combination of quality professional training, a community-based model of delivery, and hearing aids at an affordable cost provide hope for a future of access.


Young patient awaiting hearing screening and evaluation on a service trip to Nicaragua in 2019.

While the House Institute will continue to facilitate service project trips to provide hearing aids and surgical interventions in LMICs, we cannot in good conscience do so without offering the same degree of care and compassion to those in need locally. In the House Institute’s home city of Los Angeles, the lack of access to hearing aids and hearing care may be less pronounced than in LMICs yet remains a persistent health disparity. With the House Institute’s hearing aid dispensary in proximity to underserved populations, we are well-positioned to reach many people experiencing financial hardship, and whose health insurance does not cover hearing aids. We are excited to announce our commitment to partner with no-cost primary healthcare clinics to offer quality, pro bono hearing aids and audiological services for Los Angeles residents who meet eligibility requirements.

Our programs are made possible by your generosity. You can help someone hear today by supporting our hearing health efforts for underserved populations at home and abroad. Donate now.


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