Hearing loss and Deafness

Over 5% of the world’s population – or 430 million people – require rehabilitation to address their disabling hearing loss (including 34 million children). It is estimated that by 2050 over 700 million people – or 1 in every 10 people – will have disabling hearing loss.

Disabling hearing lossrefers to hearing loss greater than 35 decibels (dB) in the better hearing ear. Nearly 80% of people with disabling hearing loss live in low- and middle-income countries. The prevalence of hearing loss increases with age, among those older than 60 years, over 25% are affected by disabling hearing loss.

A person who is not able to hear as well as someone with normal hearing – hearing thresholds of 20 dB or better in both ears – is said to have hearing loss. Hearing loss may be mild, moderate, severe or profound. It can affect one ear or both ears and leads to difficulty in hearing conversational speech or loud sounds.

Hard of hearing refers to people with hearing loss ranging from mild to severe. People who are hard of hearing usually communicate through spoken language and can benefit from hearing aids, cochlear implants, and other assistive devices as well as captioning.

Deaf people mostly have profound hearing loss, which implies very little or no hearing. They often use sign language for communication.

Causes of hearing loss and deafness

Although these factors can be encountered at different periods across the life span, individuals are most susceptible to their effects during critical periods in life.

Prenatal period

Perinatal period

Childhood and adolescence

Adulthood and older age

Factors across the life span

The impact of unaddressed hearing loss

When unaddressed, hearing loss impacts many aspects of life at individual level:

WHO estimates that unaddressed hearing loss poses an annual global cost of US$ 980 billion. This includes health sector costs (excluding the cost of hearing devices), costs of educational support, loss of productivity and societal costs. Of these costs, 57% are attributed to low- and middle-income countries.

Prevention

Many of the causes that lead to hearing loss can be avoided through public health strategies and clinical interventions implemented across the life course.

Prevention of hearing loss is essential throughout the life course, from prenatal and perinatal periods to older age. In children, nearly 60% of hearing loss is due to avoidable causes that can be prevented through implementation of public health measures. Likewise, most common causes of hearing loss in adults, such as exposure to loud sounds and ototoxic medicines, are preventable.

Effective strategies for reducing hearing loss at different stages of the life course include:

Identification and management

Early identification of hearing loss and ear diseases is key to effective management.

This requires systematic screening for detection of hearing loss and related ear diseases in those who are most at risk. This includes:

Hearing assessment and ear examination can be conducted in clinical and community settings. Tools such as the hear WHO app and other technology-based solutions make it possible to screen for ear diseases and hearing loss with limited training and resources.

Once hearing loss is identified, it is essential that it is addressed as early as possible and in an appropriate manner, to mitigate any adverse impact.

Rehabilitation for hearing loss

Rehabilitation helps people with hearing loss to function at their optimum, which means they can be as independent as possible in everyday activities. Specifically, rehabilitation helps them to participate in education, work, recreation and meaningful roles, e.g. in their families or communities–throughout their lives. Interventions for rehabilitation for people with hearing loss include: