Objective: Severe to profound hearing impairment affects one-half
to three-quarters of a million Americans. To function in a hearing
society, hearing-impaired persons require specialized educational,
social services, and other resources. The primary purpose of this
study is to provide a comprehensive, national, and recent estimate of
the economic burden of hearing impairment.
Methods: We constructed a cohort-survival model to estimate the
lifetime costs of hearing impairment. Data for the model were
derived principally from the analyses of secondary data sources,
including the National Health Interview Survey Hearing Loss and
Disability Supplements (1990–91 and 1994–95), the Department of
Education's National Longitudinal Transition Study (1987), and
Gallaudet University's Annual Survey of Deaf and Hard of Hearing
Youth (1997–98). These analyses were supplemented by a review of the
literature and consultation with a four-member expert panel. Monte
Carlo analysis was used for sensitivity testing.
Results: Severe to profound hearing loss is expected to cost society
$297,000 over the lifetime of an individual. Most of these losses
(67%) are due to reduced work productivity, although the use of special
education resources among children contributes an additional 21%.
Life time costs for those with prelingual onset exceed $1 million.
Conclusions: Results indicate that an additional $4.6 billion will
be spent over the lifetime of persons who acquired their impairment in
1998. The particularly high costs associated with prelingual onset
of severe to profound hearing impairment suggest interventions aimed
at children, such as early identification and/or aggressive medical
intervention, may have a substantial payback.