SoundCheck estimates the prevalence of bilateral hearing loss by using statistical models to combine multiple sources of data. Hearing loss is defined as mild (unable to hear sounds at or lower than 25 dB, but able to hear sounds of 26 to <= 40 dB), moderate or worse (unable to hear sounds less than and at 40 dB), or any (unable to hear sounds less than or at 25 dB, i.e. the total of mild, and moderate or worse) in the better hearing ear based on a 4-frequency pure-tone-average threshold. We created prevalence estimates for each level of hearing loss by age group (0-4, 5-17, 18-34, 35-64, 65-74, 75+), sex, and race and ethnicity.

At the national level, estimates are based on the National Health and Nutrition Examination Survey (NHANES) audiology examination module (2001-2012, 2015-2018). To generate state and county estimates we included additional data including the American Community Survey (2019), Census County Business Patterns (2019); Social Security Administration Data (2019); Medicare Fee-for-Service and Advantage claims data (2019); and the Area Health Resources File (2019).

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• Rein, D. B., Franco, C., Reed, N. S., Herring-Nathan, E. R., Lamuda, P. A., Alfaro Hudak, K. M., Hu, W., Hartzman, A. J., White, K. R., & Wittenborn, J. S. (2024). The prevalence of bilateral hearing loss in the United States in 2019: a small area estimation modeling approach for obtaining national, state, and county level estimates by demographic subgroup. The Lancet Regional Health - Americas. https://doi.org/https://doi.org/10.1016/j.lana.2023.100670

Source: American Speech-Language-Hearing Association (ASHA), 2022

Description: The number of audiologists registered with ASHA divided by the total population.

Source: American Community Survey (ACS), 2021

Description: The proportion of ACS respondents who respond ‘Yes’ based on the following questions:

• Vision difficulty: “Are you blind, or do you have serious difficulty seeing, even when wearing glasses?”
• Cognitive difficulty: “Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?” (5 years old or older)
• Ambulatory difficulty: “Do you have serious difficulty walking or climbing stairs?” (5 years old or older)
• Self-care difficulty: “Do you have difficulty dressing or bathing?” (5 years old or older)
• Independent living difficulty: “Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping?” (15 years old or older)

Data source: Bureau of Labor Statistics Quarterly Census of Employment and Wages

Description: Number of workers in any of the occupations listed below divided by the total employed population.

• Construction
• Manufacturing
• Mining, oil, and agas extraction

Data source: American Community Survey (ACS), 2021

Description: Proportion of resident population who self-report each socio-demographic category.

• Age
• Race-ethnicity
• Educational attainment
• Urbanicity

Data source: American Community Survey (ACS), 2021

Description:

• Poverty rate: Proportion of households who report annual household income less than the poverty rate.
• Deep poverty: Proportion of households who report annual household income less than 50% of the poverty rate.
• Median household income: Median of self-reported household income.
• Unemployment: Proportion of workers who report being unemployed.

The prosperity index provides a single numerical measure designed to reflect the prosperity of a county. For the overall prosperity index score, 1 represents most prosperous counties and 5 represents least prosperous counties. For the component scores, 1 represents lowest risk or highest resilience and a score of 5 represents highest risk or lowest resilience.

The prosperity index is calculated for each county in the United States using standardized values of 16 indicators belonging to one of four component classes associated with prosperity. The four components represented are Economic Risk, Economic Resilience, Social Risk, and Social Resilience. Each of these four components is comprised of four indicators reflecting aspects of that dimension that are aggregated to create the component score.

The prosperity index is calculated for each county in the United States using standardized values of 16 indicators belonging to one of four component classes associated with prosperity. The four components represented are Economic Risk, Economic Resilience, Social Risk, and Social Resilience. Each of these 4 components is comprised of 4 subcomponents reflecting aspects of that dimension that are aggregated to create the component score.

Each indicator, also known as a subcomponent, was scaled to have a mean of 0 and a standard deviation of 1. This is referred to as the standardized subcomponent value. Then a clustering algorithm grouped all of the counties into 5 homogenous groups according to the standardized values thus providing a score (1 through 5) for each county for each subcomponent.

At the component level, the 4 subcomponent standardized values within the component are summed to create a component value. The counties are then clustered according to the component value to create the component scores 1 through 5.

Finally, the component values are summed for each county to create the prosperity value. The counties are then grouped into 5 classes with 1 representing the most prosperous and 5 representing the least prosperous. This 1-to-5 score is the final prosperity index score.

This tool allows researchers, policymakers, journalists, and the general public to view small area estimates of hearing loss within the United States, by county, state and population demographics. Insights derived from this tool can be used to inform our understanding of hearing in the U.S. to guide resources, policy decisions, and interventions.

Click on the drop down icon under “Select geography” on the left side of the screen to switch between the county level view and state level view.

Choose from the dropdowns under map filters from the left-hand sidebar to view results for a single demographic group or hearing loss severity measure. For example, choosing “Female” from the “Sex” dropdown will show estimates for hearing loss among females in the selected geography. Multiple filters can be selected at once, though some groups, such as people in the 0-4 age group, have very low prevalence of hearing loss.

All the data available on the map is downloadable within the popup that opens when National Hearing Loss Summary data is clicked at the top of the webpage.

Choose variables from the left-hand column to layer county or state level economic and demographic data on top of the baseline hearing loss estimates. By showing the variables as translucent circles of varying sizes, the tool allows users to clearly see how a given measure relates to the baseline hearing loss rate. For example, choosing “Audiologists per Capita” will demonstrate the relationship between an individual county’s hearing loss rate and the number of audiologists per 10,000 population.

For each county, there are three fact sheets, which can be found by clicking on “View Details” when selecting a county. The fact sheets includes 1) a series of drop downs for selecting demographics and hearing loss severity and 2) data tables showing county-level, state-level, and national-level estimates for hearing loss and the available map overlays.