Hearing Loss and Related Conditions Affect All of Us, Even Those with Healthy Hearing

Why speak up about this?  

There are close to 50 Million Americans living with hearing loss, including one-third of people between the ages of 65 and 75, and one-half of people over 75. Among 12- to 19-year-olds, researchers estimate that 17 percent show evidence of noise-induced hearing loss in one or both ears. Among US military veterans, the most common service-connected disabilities are hearing impairments. In fact, US veterans who served from 2001 to 2010 are four times more likely than non-veterans to suffer with severe hearing impairment. 

For those who are fortunate enough to have healthy hearing: Consider the fact that we all need to communicate with each other, and that hearing loss is not an obvious challenge to overcome. It is considered an “invisible disability” and one that is not often discussed – despite the impact it has on effective communications in virtually all settings. When was the last time someone volunteered to you that they had difficulty hearing and/or understanding what you were saying?

According to recent research, untreated hearing loss is associated with depression, isolation, learning difficulties, cognitive decline and other ailments. Defined as a disability by the Americans With Disability Act (ADA), hearing loss is one of several types of “communication disorders” covered by the ADA.  For title II entities (state and local governments) and title III entities (businesses and nonprofit organizations that serve the public), the goal of the ADA is to “ensure that communication with people with these disabilities is equally effective as communication with people without disabilities.”

Specifically, ADA rules that went into effect on March 15, 2011 make clear that “covered entities must provide auxiliary aids and services when needed to communicate effectively with people who have communication disabilities.”

Why are the ADA rules important for all of us?

Individually prescribed hearing aids assist in compensating for hearing loss and work very well in small, quiet spaces – but they do amplify ALL incoming sounds. Outside of a 5- to 6-foot range, the background noises that are amplified cause reverberation and distortions that interfere with hearing – leading to much less clarity and weaker comprehension.

Even if you are lucky enough to have healthy hearing, you will undoubtedly come in contact with people who are not so lucky. Whether it’s a family member, co-worker, patient, customer or neighbor, it benefits all of us to recognize hearing loss (treated and untreated loss) and make adjustments or accommodations to ensure that communication is as clear and accurate as possible. 

How do Telecoils and Hearing Loops Work Together?

The very good news about technology today: Built into the majority of hearing aids and ALL cochlear implants is a tiny copper coil (the Telecoil) that is capable of receiving an audio signal in spaces that have an audio induction (hearing) loop system installed. The wireless system works in any size space, from a desktop or small conference table to a 2,000-seat concert hall or outdoor stadium – and works seamlessly with ALL brands of hearing aids and implants.

Unlike Bluetooth systems that work well within an 8- to 10-foot range, no proprietary software or external gadgets are needed with Telecoils and Hearing Loops. There is no need to utilize an FCC frequency or remove hearing aids to connect. Choosing the “T” or “T-coil” mode on a hearing aid/implant can be a manual option, or the device may connect automatically, when in the presence of an audio loop signal. (Ask your audiologist for more information, or visit the HLAA website for info.)

Like ramps for wheelchairs, Hearing Loop systems deliver accessibility and inclusivity for those who depend upon personal hearing devices – without the burden of advance notice. Having to “borrow a ramp” to gain access to a space of public accommodation would affect 1.7 million people in the US who depend upon a wheelchair or scooter for mobility. For perspective, note the ratio of 1:29. For every wheelchair-confined person needing a ramp, there are 29 persons with hearing loss needing access.

Call to Action: Observe, Ask, Report!

EAR with slash and T for T-Coil Use

Every time you visit a hospital, theater, museum, pharmacy, library, court house, classroom or other space of public accommodation: Look for signage about Hearing Loop Systems and if you don’t see any at all, speak up and ask why not?

Report your concerns to a local Office for Equal Opportunity.  Your only responsibility is to notify the owner/manager of a public space that you have a hearing loss and to describe the accommodation that would serve you best. If not made available, document your experience and share it.  


  1. ADA’s 27th Anniversary Report https://www.ada.gov/27th_anniv_rpt.html
  2. HLAA Guide for Effective Communication in Healthcare http://hearingloss.org/sites/default/files/docs/HC_Patient_Complete_Guide.pdf
  3. US DOJ: ADA and Effective Communication https://www.ada.gov/effective-comm.htm
  4. CDC Grand Rounds “It’s Loud Out There: Hearing Health Across the Lifespan https://www.cdc.gov/grand-rounds/pp/2017/20170620-presentation-hearing-health-H.pdf
  5. Increase in Hearing Loss from aging population NIDCD Report https://www.nidcd.nih.gov/
  6. NYC Passes Legislation Mandating Hearing Loop Technology http://www.hearingreview.com/2017/04/new-york-city-passes-legislation-mandating-hearing-loop-technology-public-assembly-areas/
  7. Induction Loop usage in Western Europe 
  8. US DOJ 27th Annual Report on ADA https://www.ada.gov/27th_anniv_rpt.html
  9. It Takes More than Ramps to Solve the Crisis of Healthcare for People with Disabilities https://dredf.org/healthcare/RIC_whitepaperfinal.pdf
  10. Hearing loss hits a younger generation https://www.chicagotribune.com/lifestyles/health/sc-hlth-young-hearing-loss-0913-story.html
  11. Getting People With Hearing Loss in the Loop by David Myers https://journals.sagepub.com/doi/full/10.1177/1745691618808506# 
  12. World Health Organization Safe Listening Devices and Systems https://apps.who.int/iris/bitstream/handle/10665/280085/9789241515276-eng.pdf
  13. Hearing Loops: The Preferred Assistive Listening Technology http://www.aes.org/technical/documentDownloads.cfm?docID=509 
  14. Office of the Comptroller of the Currency: Compliance/BSA https://www.occ.treas.gov/topics/compliance-bsa/index-compliance-bsa.html 
  15. The Rising Tide of ADA Litigation Against Health Care Entities https://www.jdsupra.com/legalnews/the-rising-tide-of-ada-litigation-18232/
  16. Hearing aids may reduce the forgetfulness and mental confusion tied to hearing loss https://www.businessinsider.com/r-hearing-aids-may-slow-cognitive-decline-tied-to-hearing-loss-2015-4  
  17. Hearing Loss Summary by the Mayo Clinic
  18. Hearing Loss in US Veterans
  19. Severe Hearing Impairment Among Military Veterans
  20. Consumer Perceptions of the Impact of Inductively Looped Venues on the Utility of Their Hearing Devices
  21. Mobility Device Statistics
  22. What Can Noise Do to Your Hearing?
  23. ADA’s Technical Assistance Program for Businesses and Government

Hearing Loss is Not for the Weak or Timid

Young Male at Work - Protective HeadphonesIn theory, weakness is the lack of strength needed to overcome a challenge or achieve a goal and being timid is a “flaw” that compounds weakness because it rules out speaking up about the obstacles in your way.

Average hearing ability is a tool that we take for granted, until it slowly or suddenly abandons us. Even caring for someone challenged with a hearing loss is probably not enough of an experience to make any claim of understanding what it is really like.

In the past 18 months, while marketing audio induction loop systems for public spaces, I have learned the following about hearing loss and what we can all do to prevent, treat and accommodate for it:

> Hearing loss can happen to anyone at any age, but can be prevented in many cases. Sadly, noise-induced hearing loss (NIHL) is actually on the rise. (Helpful video and article by Julia Belluz explains this.)

> Untreated hearing loss often leads to cognitive decline and dementia – on top of the high risk for ongoing social isolation, lower wages, greater educational stress and other complications. (More on audiology and neurology here.)

> Assistive hearing devices (hearing aids) to help “treat” hearing loss range in price from $59 to about $7000. They amplify sounds within a 6′ radius and deliver an audio signal to the part of the brain that processes sound. (The sooner that part of the brain is “re-engaged” the better.)

> The majority of hearing aids are equipped with a “telecoil” for using telephones, and to pick up the clear audio signal available in noisy, public spaces that are “looped” with a loop amplifier and copper coil loop.

> Hearing Aids are rarely covered by medical insurance – not even Medicaid or Medicare.

> Veterans are entitled to free hearing aids through the Veteran’s Adminsitration. That’s good because hearing loss is the number one disability caused by active duty in the military.

> Hearing aids customized for an individual’s specific hearing loss are prescribed by hearing aid professionals — audiologists and hearing aid dispensers. Typically, this is done after a medical exam has ruled out medical treatment to resolve the hearing loss.

> “Personal sound amplifiers” are available for sale, over-the-counter (OTC), at a much lower cost than devices prescribed by hearing aid dispensers. They are not customized.

> Captioned phones for those with hearing loss are paid for by a tax we all pay in our phone bills. Manufacturers are paid directly for all captioned phones installed.

> Emergency call phones in mass transit and airports are ADA-required (Americans with Disabilities Act) to accommodate those who depend upon hearing aids and cochlear implants. An amplifier and copper coil loop built into each phone blocks background noises and delivers crystal clear sound to the telecoil in hearing devices.

> The ADA requires assistive listening technology be available to those with hearing loss in public spaces where they need to hear and understand spoken language, or enjoy the audio experience. (Hearing loops are the “gold standard” option.)

> Think of wheelchair users and understand that wheelchair ramps and hearing loops have a lot in common, at a 1:25 ratio — ramp to loop users.

The timid do not normally speak up and ask for help when they do not hear well enough to understand what is being said. They may rely on others for assistance or simply bluff while involved in a conversation. Withdrawing from social activities is common. Missing flights, instructions, invitations, scores, and other verbal communications is also common.

What is most scary about hearing loss is needing to understand the questions, and the answers, from medical care providers while anxious, confused or stressed — at a doctor’s office, surgical suite or emergency room. The Hearing Loss Association of America(HLAA) is paying extra attention to this concern and has published a Communications Access Plan that will work in any health-related environment. The full guide is simple to download.

HLAA members have also made it clear that basic medical record-keeping seems flawed because a patient’s hearing ability is not flagged at the first level of patient identification. Routine screening would help immensely by taking the onus off the patient to self-identify. More details on that here.

If hearing loss is not for the weak or timid, it must be ok for those who are strong and bold? (Not exactly.)

The burden is on all of us, especially those who still have typical hearing, to do more to accommodate and be inclusive. Please share my contact information with anyone you know who is

  1. an owner or operator of a public space that is not yet “looped” or
  2. capable of funding the installation of hearing loops in under-funded venues or
  3. capable of funding for hearing aids for those who can’t afford them.

My email address is peggy@ad4h.com. Thank you.

CDC Report on Disability

cdc-logo 600x300px

According to the CDC, persons with disabilities face greater barriers to health care than do those without disabilities. To identify characteristics of non-institutionalized adults with six specific disability types (hearing, vision, cognition, mobility, self-care, and independent living), and to assess disability-specific disparities in health care access, CDC analyzed 2016 Behavioral Risk Factor Surveillance System (BRFSS) data.

Click here for full report.