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Hearing loss is on the rise. A new wave of tech can help


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Between pounding jackhammers and screeching machines, the cacophony of a construction site is unpleasant for most. Not to Christine, an 18-year-old from Alabama. After getting her first pair of hearing aids, Christine found the sounds profound.

“It was surprising to stop and hear what things actually sound like to other people,” she said. “I was sitting next to a construction site just to hear the different sounds. I like to listen to the machines running. My favorite are the 18-wheelers that drive around the site.

“The mess sounds better than before.”

Christine has struggled to hear out of her left ear all her life. In March, she was prescribed her first pair of hearing aids. In addition to dramatically improving her hearing, she also notably improved her balance.

Christine is one of the 38 million Americans who have some degree of hearing loss. Hers was genetic, but many more are put at risk by exposure to loud noises. The World Health Organization estimates that more than a billion young adults are at risk of hearing loss “due to unsafe listening practices.”

Although hearing loss is widespread, the adoption of hearing aids is not. An estimated 13% of people aged 45 to 64 would benefit from hearing aids, according to a 2019 study, but just over 2% actually get them.

Some of that has to do with cost. Prescription hearing aids typically start at $1,000 and can run up to $4,000. About a third of that covers the price of the actual hearing aids, said Barbara Kelley, executive director of the Hearing Loss Association of America. The rest of the amount covers hearing tests, device fitting and return visits to the audiologist, which are crucial services for those with severe hearing loss.

But that could soon change. Last year, the Food and Drug Administration allowed the sale of over-the-counter hearing aids for people with mild to moderate hearing loss. Many OTC hearing aids run under $999, and prices are expected to drop as competition stiffens. The hope is that by making hearing aids cheaper and easier to buy, more people who need them will have access.

“Hearing health is a primary health concern. It’s just like knowing your blood pressure or your weight, because hearing loss is linked to quality of life,” Kelley said. “If we can get more people to take that first step sooner rather than waiting five to seven years after finding out they have hearing loss, that’s a good thing.”

Sony

New brand, new brands

Making hearing aids cheaper and more accessible is a strong first step. But there are other barriers that stop people from getting the hearing aid they need, says Kevin Franck, former chief of research at Harvard Medical School’s Department of Otolaryngology.

“There are countries where (hearing aids) are free and still a fraction of the people who need them get them,” Franck said. “It doesn’t mean cost isn’t a factor, but it’s not the only factor.”

Another factor is stigma. Hearing aids are associated with aging, and many people would rather struggle with their hearing than conspicuously use hearing aids. Although this stigma persists to this day, both Kelley and Franck say it appears to be diminishing among young people. Younger generations are used to wearing earbuds regularly, which makes the leap to hearing aids less difficult.

The bigger problem, says Franck, is that hearing aids cannot completely cure hearing loss. Prescription glasses or contacts can restore a person’s vision, but hearing aids don’t work the same way. (That’s why Franck is big on preventative measures — like buying noise-canceling headphones so you don’t have to turn up the volume to drown out nearby sounds.) Once enough sensory cells in the ear are destroyed, d’ r always be some level of distortion, even with a perfectly adjusted pair of hearing aids.

That’s the experience of Catie, who is in her 20s. “My experience with her so far has been mostly ups, but a few downs,” she said. “I hear too much background noise…it’s hard to focus sometimes.”

“It takes a long time to get used to,” she added. “That can take about six months to a year.”

Since the FDA allowed the sale of OTC hearing aids by the end of 2022, consumer technology brands such as Sony and Jabra have hit the market. So far, their efforts have included white labeling — taking hearing aid products made by medical companies and rebranding them. Jabra’s Enhance hearing aids were formerly Lively, a connected healthcare company owned by Best Buy.

The brand recognition of Sony, Jabra or Bose can provide some comfort for hearing aid novices, Kelley said. But the real impact will be when these companies create products from the ground up, forcing hearing aid manufacturers to compete.

Young people are used to wearing earbuds all day. The normalization of such hardware is thought to reduce the stigma attached to hearing aids.

David Carnoy/CNET

According to Franck, Apple has approached the possibilities of hearing aid chips in its consumer market. To develop spatial audio, an AirPod Pro feature that recreates surround sound, the tech giant needed a deep understanding of the shape of the ear. And to create the Transparency noise-cancelling mode on AirPods Pro and AirPods Max, Franck added, Apple needed sophisticated feedback limitation.

So even though Apple doesn’t make hearing aids, the company could be the biggest disruptor to the OTC market because it wants to do just about anything else. “Companies like Apple are figuring out how to do all that and more, and not carry the stigma of the hearing aid,” Franck said.

In fact, the AirPods Pro can practically be used as hearing aids. If you download an app that tests your hearing, that data can be entered into an iPhone’s Health app and then used to adjust the settings of the AirPod Pro in Transparency Mode, using the microphones of the device to amplify the appropriate sounds. Apple doesn’t make a big deal out of it, Franck says, because that could lead the FDA to classify the AirPods Pro as a Class II medical device, which would subject the product to regulation.

Access to hearing aids

Catie says her prescription hearing aids would cost $12,000 if insurance didn’t cover them. About 26 million Americans, 8% of the population, do not have health insurance. Catie is encouraged by the advent of OTC hearing aids and hopes they will soon become more available.

“It would be great for them to be more accessible to everyone,” she said. “Mine were so hard to come by.”

Currently, OTC hearing aids are only for people with mild to moderate hearing loss. More severe cases will still require a prescription. Consultations with audiologists are necessary, Franck said, to ensure that hearing aids are properly molded to the ear and to ensure that severe hearing loss cannot be improved by a cochlear implant.

“We have to walk before we can walk,” said Franck. “My hope is that this is where we start and we make progress from there.”

More about hearing aids

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health care provider with any questions you have about a medical condition or health goals.

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