Hearing Health Equity & Community-Based Approaches: Introductions

By Carrie Nieman, featuring Kevin DeMario


Hearing loss is common as we age but hearing aid use, the primary approach to managing hearing loss, is not. Nationally, only about 15-20% of older adults with hearing loss use hearing aids.  As with almost every other health condition in the United States, disparities in hearing health care exist based on race/ethnicity and socioeconomic position. Rates of hearing aid use among minority and low-income older adults hover around 10% and, oftentimes, lower; but data are lacking. Much of what we know from an epidemiological standpoint about age-related hearing loss comes from large prospective studies, such as the Framingham cohort and the Beaver Dam study, that are composed of primarily white participants. 


Frank Lin highlighted in his previous post that what we know about the potential implications of age-related hearing loss is changing. Age-related hearing loss is almost universal but it may not be as benign a process as we once thought. Access to hearing health care is no longer about access to hearing aids but, rather, access to the tools that may be essential to aging well. 


A critical component of the Cochlear Center for Hearing and Public Health’s mission is to understand and address hearing health equity through community-based efforts alongside policy, research, and education. We will dive deeper into some of the drivers of disparities and potential solutions in the arena of hearing health care in future blog posts. One current effort within the Cochlear Center is the HEARS research study, an NIH-funded randomized controlled trial of an affordable, accessible hearing care program delivered by community workers using over-the-counter hearing technology.


As the HEARS study is ramping up, we have welcomed a new Research Assistant, Kevin DeMario.  To introduce Kevin and remind the rest of the team of the broader discourse around health equity, particularly for our work based here in Baltimore, the HEARS team took a field trip.  We recently attended The Atlantic’s Forum on Health Equity, Healing the Divide, which posed the question, what will it take to advance health equity in America? I sat down with Kevin to get his thoughts on an event that challenges each of us to consider our part. 


Carrie: What part of the forum Healing the Divide was the most salient for you?

Kevin: Kiarra Boulware’s story, as featured in the recent Atlantic article, “Being Black in America Can be Hazardous to Your Health”, was one of the most valuable parts of the forum. Kiarra began her story as a resident of Penn North Recovery which is a pioneering community organization that provides behavioral health and recovery services here in Baltimore, led by Steve Dixon. Kiarra talked about her experience becoming a Community Outreach Worker at Penn North Recovery and the power of feeling like, “...sometimes help doesn’t feel like help”. Kiarra’s story reminded me of a quote that I came across when studying philosophy as a graduate student.  Some people attribute the quote to Goethe and I think the quote applies to a lot of the work we do in HEARS, it goes something like “If you treat someone as they are, they will remain so. Treat someone as the person they can be and are capable of being and they will become who they can be.”  For me that highlights what our work is all about – not only recognizing but utilizing the tremendous strengths of our community workers and partners.


Video of Kiarra’s story:

Healing the Divide: Kiarra's Story

Grounded in the 160-year legacy of the magazine, AtlanticLIVE brings the unparalleled journalism of The Atlantic to life through singular event experiences, on stage and off. For more information, please visit: https://www.theatlantic.com/live/


Carrie: What part of the forum did you find surprising?

Kevin: At the Cochlear Center, despite my short time here, I have become aware of the importance of listening. However, there is a difference between listening and really listening. This point was elucidated by Steve Dixon citing The Tyranny of Experts. Steve talked about how there are many brilliant minds at work to improve the Baltimore community, but these minds often do not take the time to listen to the people at the ground level, who they are trying to engage with in their programs. This disconnect causes programs to fail or, at least, not succeed as much as they could. A little listening can go a long way.


Carrie: Did the forum cause you to change your perspective or think about something differently?

Kevin: Dr. Leana Wen, the Commissioner of Health for Baltimore City, changed my perspective on how research can be viewed by community members, including Baltimore residents. Dr. Wen shared that it is not uncommon that when city health workers go to resident homes to offer services during a time of need, residents will ask one of two questions: (1) “What politician do you represent?” and/or (2) “What study is this for?”.  This statement really made me take pause and put into perspective the long history our academic institutions have within Baltimore communities.  It makes you think about how a research team like ours enters into that history and conservation.  The comment made me think a lot more about what we can do to change that conversation for the better.  It’s our job to make the extra effort to demonstrate to the individuals and the communities with which we work that we are here to partner, to listen, and bring what we can to a table that already has all of the assets that our community partners bring.   


Video of Leana’s interview:

Health Systems Transforming Communities

Leana Wen, Baltimore Commissioner of Health sits down with The Atlantic's Steve Clemons to look at how local leaders can help community residents achieve positive health outcomes. Grounded in the 160-year legacy of the magazine, AtlanticLIVE brings the unparalleled journalism of The Atlantic to life through singular event experiences, on stage and off.