Barriers to Receiving Necessary Hearing Care Among US Children

Objective We aim to clarify the national scope of unmet pediatric hearing care needs and identify specific barriers to hearing care. Study Design Cross-sectional study of a nationally representative data set. Setting This study is based on the combined 2016 and 2017 National Survey of Children’s Health. This survey covers the physical and emotional health, access to care, and social context of US children and adolescents aged 0 to 17 years. Methods Analysis of parent-reported responses of children’s hearing status, access to care, and perceived barriers. Results Overall, 0.3% (n = 206,200) of US children surveyed reported needing hearing care, which was not received. A further 1.3% (n = 934,000) reported deafness or problems with hearing, and of these, 6.4% (n = 60,000) reported not receiving necessary hearing care. Rates of insurance coverage between children with deafness/hearing problems and the general population were similar (91.7% vs 93.9%); however, deaf or hard-of-hearing children with unmet hearing care needs were more likely to be from non-White backgrounds (P = .009) and to lack health insurance coverage (P = .001). Rates of unfulfilled hearing care by reason were as follows: 57.5% without eligibility for the service, 45.4% reporting the service was not available in their area, 53.7% with difficulty obtaining an appointment, and 53.5% reporting issues with cost. Conclusion Over 200,000 children annually do not receive necessary hearing-related care despite high rates of insurance coverage, and nearly 60,000 of these children are deaf or hard of hearing. Cost, eligibility for and distribution of services, and timely appointments are the primary barriers to hearing health care.