First published 07 July 2022

EHIMA presents facts and arguments for better hearing care.

59 percent of all hearing aid users believe they should have gotten treatment sooner. This is a key finding of the new EuroTrak study about hearing care in Germany, which was first presented to the public on June 1 as part of an online panel by “Initiative Hörgesundheit” (German Hearing Health Initiative), a coalition of stakeholders in the German hearing care sector. The study is the latest EuroTrak survey conducted by the European Hearing Instrument Manufacturers Association (EHIMA) and the German Hearing Industry Association (BVHI).

The EuroTrak studies series was first launched in 2009 to raise public awareness of the most important issues surrounding hearing loss and hearing care. So far, the study has been conducted in 16 countries, surveying over 630,000 people. EuroTrak is designed as an online panel study based on self-reporting by participants. The previous study on Germany was published in 2018.

To make the hearing study accessible to all stakeholders involved in hearing care, the German Association for the Hard of Hearing (DSB), the European Union of Hearing Aid Acousticians (EUHA), the German Professional Association of Ear, Nose and Throat Doctors (BVHNO) and BVHI joined forces in a shared initiative called Initiative Hörgesundheit. The main demand of the initiative are regular hearing-screenings for people aged 50 and older, financed by the German statutory health insurances.

Not everyone who thinks they have hearing loss goes to an ENT doctor

In Germany, around 9.24 million people consider their hearing ability to be impaired. That is 11.1 percent of the total population. Most of those affected, approximately 9.03 million, are adults. From the age of 50, the frequency of self-assessed hearing loss increases significantly. While 6.8 percent of people in the 45-54 age group consider themselves to be experiencing hearing loss, this figure rises to 12.5 percent among people aged 55-64. Among the 65- to 74-year-olds, one in five considers themselves to be experiencing hearing loss (20.2%), and from the age of 74, the figure is already one in three (35.5%).

Not everyone who considers themselves to be experiencing hearing loss has his or her hearing loss assessed by a doctor. Of the 9.24 million, only about 7.48 million visited an ENT- or family doctor. This means that 19 percent, or 1.75 million people, do not get a medical diagnosis. After medical consultation, 5.36 million received a positive diagnosis (hearing loss requiring treatment). In the end, a total of 3.8 million people had hearing aids fitted. That is 41.1 percent of the population who consider themselves to have hearing loss.

The large proportion of people living with self-assessed hearing-loss who do not seek medical assessment highlights the need to further educate about the risks of untreated hearing loss. However, the study indicates a growing awareness of the multiple benefits of hearing care: The coverage rate among individuals with self-assessed hearing loss increased from 31.8% to 41.1% from 2009 to 2022, equaling a share of approximately 4.6% of the total German population, in 2022. Compared to the first study in 2009 (4.2%), this shows an increase of hearing aid-uptake of ten percent.

Hearing aids are worn for an average of 8.9 hours a day

On average, 3 years pass between becoming aware of the hearing loss and the fitting. The average life of hearing aids before resupply is generally 6 years. Here, Germany is slightly above the average of other countries. The average daily wearing time is 8.9 hours; 28% of users even wear their hearing aids for more than 12 hours. Only 5% of prescribed hearing aids are never worn. The 5% share of unused hearing aids proves high therapy compliance in hearing care. For example, the share of prescribed medications for chronic diseases that are not taken, is up to ten times higher, estimated internationally at between 20% and 50%. (1)

One-third of 50- to 60-year-olds never had their hearing tested

EuroTrak also shows where additional efforts for broader hearing health awareness are needed: More than a third of surveyed participants (34%) never had their hearing tested. Even among the 50- to 60-year-olds, one third say that they have never taken a hearing test. This age group is particularly affected by the beginning of age-related hearing loss. If age-related hearing loss is detected and treated early, further health risks associated with untreated hearing loss can be avoided. For precisely this reason, the German stakeholders of “Initiative Hörgesundheit” urgently call for hearing screenings from the age of 50 to be financed by the German health insurance system.

Only one-third of Germans with untreated hearing loss are aware of their health insurance coverage

In Germany, anyone with statutory health insurance and a prescription by an ENT-doctor receives hearing care up to a fixed amount. Still, the knowledge that this means the cost of hearing aids can even be covered entirely by health insurance is not widespread among hearing aid non-owners. Only 35 percent are aware of this, 48 percent state they do not know. A full 17 percent believe that their hearing aids would not even be partially covered by their health insurance. This deficit in public knowledge shows that there is considerable potential to improve coverage. Initiative Hörgesundheit therefore proposes and engages in concerted awareness campaigns by all hearing care stakeholders.

When asked about the 10 most common reasons why they do not get hearing aids, 68 percent of those severely affected by hearing loss (2) cite the fact that they “cannot afford” them. 60 percent say they have “more important problems” to take care of. This indicates two things: First, most individuals with hearing loss that do not have hearing aids are not aware that they can be provided with hearing aids without paying extra. Second, it shows that many people lacking hearing care are not (yet) aware of the consequences of not getting treated. It is precisely these people that have to be reached through qualified consultations with hearing care professionals or ENT specialists as well as general information campaigns.

Awareness of health risks must be increased

34 percent of people surveyed associate hearing loss with depression. Moreover, 26 percent suspect a connection of untreated hearing loss with sleep disorders, and 21 percent with high blood pressure. However, 43 percent also believe that hearing loss is not associated with any of the health problems mentioned in the survey. Here too, awareness of hearing loss-related health risks must be further increased, according to Initiative Hörgesundheit.

83 percent of hearing aid users feel their expectations have been met or exceeded

What situations are particularly important to people living with hearing loss? Where and when do they place particular importance on hearing well? Most people experiencing hearing loss cite those situations in which they are in direct communication with others. “At home with the family” is mentioned by 49%, 47% say “watching television together” and 45% “telephone conversations”.

Most hearing aid owners say hearing aids generally improve their social participation. 65% say their ability to communicate effectively in various situations has improved. 59% report a higher sense of security and 58% say their ability to participate in group activities has increased. 53% report an improvement in their social life, 71% feel safer in urban environments and 66% report increased safety while either driving their car or riding an e-bike or bicycle.

In general, EuroTrak 2022 Germany confirms that hearing aids meet or exceed the expectations of their owners. This is said by 83% of hearing aid users. As expected, 89 percent of hearing aid users in Germany are also satisfied with the professionalism of their hearing care professional.

59% of all hearing aid users believe they should have had their hearing aids fitted sooner

As was mentioned at the beginning of the article, 59% of all hearing aid users regret not having decided to seek hearing care sooner. When asked what these people believe they missed out on, because of their late decision, most cited an improved social life (66%), increased mental well-being (52%) and better performance at work (24%).

These findings of the wearers must be passed on in consultations to those living with hearing loss who have not yet decided to be fitted with hearing aids. EuroTrak has once again shown that there is a need for further public education on health risks of untreated hearing loss and on health insurance benefits. With over eleven percent of people claiming to be experiencing hearing loss, the actual share of the total population in need of hearing instruments might likely be higher, since not everyone is willing to admit having a hearing loss – even in an online survey such as EuroTrak.

The complete survey for EuroTrak Germany 2022 can be accessed at www.ehima.com/surveys.

A comprehensive German-language analysis of the central findings has been compiled by BVHI in collaboration with Initiative Hörgesundheit and and is accessible with additional information material at www.initiative-hörgesundheit.de/eurotrak.

For more information on the German stakeholders’ call for hearing screenings from the age of 50, go to: www.initiative-hörgesundheit.de/hoervorsorge

Notes:
(1) European Network to Advance Best Practices and Technology on Medication Adherence: Mission Statement, in : Front. Pharmacol., 11 October 2021. https://doi.org/10.3389/fphar.2021.74870
(2) TOP 50% of hearing-impaired individuals without coverage, proportion of survey respondents classified as more hearing impaired based on factor analysis.