Steve has written a couple of articles recently exploring the possibilities for hearing aid provision of the future. He has laid out his arguments as to why self-fit hearing aids would be an ideal product for many people with hearing loss. As a professional, and someone with hearing loss, I agree but have some concerns. I will explore that in a later article. In this article, I would like to address the reasons given for non-adoption of hearing aids by people with hearing loss. I would also like to look at the penetration rate of hearing aids in the possible market in the two biggest markets in the world. Without further adieu, let's get on.
The term penetration rate is used within the hearing aid industry to discuss the number of hearing aids dispensed versus the forecasted or suspected market. The penetration rate has always been low, but in recent years, we have seen an increase.
According to industry surveys, only 34% (1) of the people who could be wearing a hearing aid in the US are and 41% in the UK (2). While it is 34% in the US, that has grown from a low 24% in the last five to seven years. Considering that there is good access to free hearing aids in the UK from the NHS, 41% is surprisingly low.
No matter, both adoption figures are low for people with a problem that could be solved by easily accessible technology. So why aren't people getting hearing aids if they need them? What are the impediments to adoption?
Why aren't people buying them?
MarkeTrak in the US is always a treasure trove of information for the hearing aid industry and according to the latest survey, the reasons why are as follows:
The first group are people who know they have a loss but haven't done anything about it. They have taken no action, not even seen a hearing care professional:
- Can hear well enough 43%
- Too expensive 40%
- Can't afford 24%
- Have other priorities 20%
- No coverage/insurance 19%
- Too embarrassing 17%
- Not enough benefit 17%
- Do not know where to get tested 14%
- Too noticeable/visible
- Afraid of becoming dependent 12%
- Unattractive 12%
- Uncomfortable physically 12%
- Too young to have hearing aids 11%
The second group were people who had a hearing test and were recommended a hearing aid by a professional:
- Too expensive 42%
- Can't afford 26%
- Can hear well enough 22%
- No insurance/coverage (affordability again) 21%
- Got PSAP/Hearing Aid directly 17%
- Have other priorities 14%
- Too embarrassing to wear 14%
- Not enough benefit to justify 13%
It is clear from the answers given that the biggest impediment to hearing aid adoption is the cost. If you spend any time in hearing loss forums you will be familiar with that concept. A constant thread is shock at the cost of hearing aids. In all honesty, if we look at the reasons given, they fall within the cost or stigma equation. Cost is the reason why Steve and others believe that technology can help.
Is it cost, or value?
I am not one of the interminable gobshites (Irish technical term) who say things like "cost isn't the issue". Believe me, there are many of them, I do understand that some people, simply don't have the money, full stop. Having said that, I do also know that for some people, it is more of a value versus cost equation. These people may have the finances to proceed but aren't convinced that the value that hearing aids deliver outweighs the cost.
For me as a hearing aid user, the value of them to me in my day to life is practically incalculable. I get through my day without massive effort just to understand what people are saying, it means I am less tired at the end of the day and more likely to socially engage.
That means an easier life, it also means that I will engage socially, thereby keeping more active which has a knock-on effect on my general well being. For me, the equation is simple. I understand that for some, it may not be as simple.
What do you need to ask yourself?
First of all, if it is a value versus cost equation, I believe that you shouldn't dismiss the cost without some real, honest thought. Honesty can be difficult, especially when it is with yourself. Ask yourself is your hearing loss interfering with your life and happiness. It is a simple but complex question. A question that is worthy of real thought and discussion with the important people in your life.
If the answer is yes, even a tentative yes, well then the only other questions should be what technology level of hearing aids are good for my lifestyle and which provider in my area has the best reputation for a high quality of care.
It really is as simple as that, your health, wealth, general and emotional well-being are the most important things. Untreated hearing loss will mess around with all of them, and the effects will only get worse.
What if it is cost?
If you simply can't afford hearing aids, no matter what, well then begin to look at foundations or charitable providers within your area. If you live in the UK or Ireland, free at source hearing aids are available from the respective health services.
OTC may help
The introduction of the Over The Counter regulations, hopefully, some time in 2021 in the US, should begin to help with lower-cost options. After all, that is why the politicians wrote it into law, to widen access to hearing aids.
It will probably mean the introduction of lower-cost self-fit options to the US market. These devices will certainly not be for everyone though, they will only cover mild to moderate hearing losses. On top of that, to use them with success, you or someone you know will have to be at least a little techie.
There are already some hearing care providers in the US offering low-cost options. They are entry-level devices and you won't get all of the accompanying services that you could expect with the traditionally priced options, but they are an option.
There is also a growing number of non-traditional devices available for relatively low prices such as IQBuds from NuHeara and BeHear Access from Alango Technologies. I also recently had a look at a different type of device from Nuance Hearing called the Sound Selector. These devices are relatively low cost and can help you to hear better in different sound situations.
The stigma strikes back!
It is also obvious from the answers that stigma still plays a part in the decision process. My only answer to that is to get over yourself you tosser.
The stigma is in your head
I have said it before, and I have no doubt I will say it again, there is no stigma with hearing loss other than the little voices in your head. Those voices that tell you that you are getting old, those voices that ask you what will people think. The voices that tell you that having to wear a hearing aid is some sort of statement on you, your age, your worth. The voices in your head are lying to you!
The Voices in your head are lying to you, not only lying, but actively doing you harm. Don't listen to the arse, it's time to get over yourself tosser
I don't understand why wearing hearing aids would embarrass you, although I am infamous for not being too worried about how people view me. My answer when people say this, is are they not more embarrassed that their worry about what other people think stops them from helping themselves? This embarrassment is born of the idea that hearing loss is some sinful statement on who they are, that it is a direct attack on their worth. That's all arse (Another Irish technical term) complete and utter arse.
Don't listen to the arse
Don't listen to the arse, hearing loss is not a statement on you, on who you are, on how old you are, it merely is. No more and no less. However, not doing something about a hearing loss that is affecting your life is a statement on you. Being too vain or proud or caught up with the demons in your head that you don't take steps to deal with your hearing loss rather succinctly makes a statement about you.
Hearing aids aren't about getting old, they help you stay young
I wrote an article recently exploring the missing message, I realised that we as professionals weren't communicating the benefit of hearing aids well. The simple truth is that hearing aids help you stay young by allowing you to engage in an active social life.
Staying young is all about being active, healthy and socially engaged. Being active as we get older helps keep us healthy and happy. Being socially engaged helps keep our minds sharp. Being socially engaged helps keep us happy, hearing aids will enable all of that.
Because if you have untreated hearing loss you are more likely to be socially isolated, and that plays havoc with our happiness and has a direct knock-on effect on our health. So not only are the voices in your head lying to you, they are actively doing you harm.