A new study that maps the prevalence of bilateral hearing loss in the United States by state and county finds that rates of hearing loss are higher among men, non-Hispanic Whites, and residents of rural areas. Bilateral hearing loss is hearing loss in both ears.  

West Virginia, Alaska, Wyoming, Oklahoma, and Arizona had the highest rates of hearing loss, while the District of Columbia, New Jersey, New York, Maryland, and Connecticut had the lowest, according to data from Sound Check Map.

States and Cities/Metropolitan Areas with Highest Hearing Loss Prevalence  

Top States Top Cities/Metro Areas 
1. West Virginia
2. Maine   
3. Montana 
4. Wyoming 
5. Vermont 
6. New Mexico
7. Arkansas 
8. Kentucky 
9. Oklahoma 
10. Oregon 
1. Tucson, Arizona 
2. Pittsburgh, Pennsylvania 
3. Tampa, Florida 
4. Oklahoma City, Oklahoma 
5. Providence Metro Area, Rhode Island 
6. Cleveland, Ohio 
7. Louisville, Kentucky 
8. Rochester, New York 
9. Buffalo, New York 
10. San Antonio, Texas 

States and Cities/Metropolitan Areas with Lowest Hearing Loss Prevalence  

Top States Top Cities/Metro Areas 
1. D.C. (District of Columbia) 
2. Utah 
3. Maryland 
4. New Jersey 
5. Georgia 
6. New York
7. California 
8. Illinois 
9. Texas 
10 Virginia 
1. Washington, D.C. 
2. San Jose Metro Area, California 
3, Atlanta, Georgia 
4. Raleigh, North Carolina 
5. Houston, Texas 
6. Dallas, Texas 
7. New York, New York 
8. Memphis, Tennessee 
9. Austin, Texas
10. Salt Lake City, Utah  

Breaking Down Hearing Loss Prevalence

The researchers identified that the occupations most associated with hearing loss besides mining were in retail and restaurant settings. They also found that hearing loss increases significantly starting at age 35. 

The prevalence research supporting the map development was published today in The Lancet Regional Health – Americas. 

The Sound Check study, conducted by researchers at NORC at the University of Chicago and funded by the Centers for Disease Control and Prevention, found that nearly 38 million Americans—more than one in nine—suffer from some form of bilateral hearing loss. The rate increases to just under one in seven for people ages 35 and older and one out of every 1.4 people ages 75 and older.  

“These results emphasize the importance of hearing loss as a national concern,” says David Rein, senior fellow at NORC at the University of Chicago and the principal investigator of the study. “The number one risk factor for hearing loss is aging, but the map tells us that where you live impacts your hearing as well. Surprisingly, people living in urban areas with large populations and traffic noise have less hearing loss prevalence than people in rural areas.” 

The Sound Check study researchers note that because their findings estimate hearing loss by state and by county, the estimates can be used to target hearing loss prevention, diagnosis, and treatment strategies.  

“We hope that public health officials across the country make it a priority to advocate for improved screening for adults just as they have for newborns and young children. This study and the map show that hearing loss needs attention, and that prevention may be possible,” says Karl White, director of the National Center for Hearing Assessment and Management, Utah State University.  

People in rural areas may be at higher risk for hearing loss because of noise exposure from outdoor work using heavy machinery and from recreational activities involving all-terrain vehicles or the use of firearms for hunting and recreation. Consistent use of hearing protection can reduce the risk of hearing loss, even among people who engage in recreational firearm use. 

Hearing loss has serious impacts on health and quality of life—inhibiting speech and language development in children, elevating family stress, and contributing to work and social problems among adults. In older adults, hearing loss is also associated with higher risk of dementia, depression, falls, heart attack, and premature death. 

“We need to recognize the impact that hearing loss has on our emotional, social, and cognitive health. In many cases, hearing loss can be prevented and almost all forms of hearing loss can be successfully treated so that people can enjoy their lives without straining to hear what others are saying,” Smiley says.  

Further reading: Best of ‘HR’ in 2023: Editor’s Picks

More on the Sound Check Project 

The Sound Check project estimated the national prevalence of hearing loss in both ears based on the audiology examination module of the National Health and Nutrition Examination Survey (NHANES). Results were stratified by age, race and ethnicity, and gender. To generate state and county estimates, the researchers used a statistical modelling approach called small area estimation to predict variation in hearing loss in different geographical areas using county data for other indicators of hearing loss. 

Partners supporting NORC included experts from ASHA (American Speech-Language Hearing Association), NCHAM (The National Center for Hearing Assessment and Management), and Johns Hopkins University Cochlear Center for Hearing and Public Health. 

Photo: Screen grab of the map from Sound Check Map.