Hearing loss and healthcare expenditures in the United States
Evidence of a public health market failure
Bibliographic Data
| ID | 22080112 |
|---|---|
| Authors | Yuval Arbel (0000-0003-4365-6280, Bar-Ilan University), Yifat Arbel (Bar-Ilan University), Netanel Kerner (Hebrew University of Jerusalem), Oriya Kerner (Technion – Israel Institute of Technology) |
| Year | 2026 |
| Volume | 14 |
| Pages | 1829845-1829845 |
| Publication date | 2026-06-08 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Frontiers in Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2296-2565 • E-ISSN: 2296-2565 |
| Publisher | Frontiers Media SA (PUBLISHER • CH) |
| DOI | 10.3389/fpubh.2026.1829845 |
| PMID | 42338529 |
| OpenAlex | W7163866674 |
| Language | EN |
| References cited | 16 |
Background: Hearing loss (HL) is one of the most prevalent chronic health conditions worldwide, affecting approximately 48 million adults in the United States. Despite the availability of effective treatment technologies, hearing aid adoption remains persistently low, with only 14-30% of individuals who could benefit from hearing aids actually using them. A growing body of evidence indicates that HL is associated with higher healthcare utilization, reduced labor market participation, cognitive decline, and diminished quality of life, implying substantial economic and societal costs. Objective: To integrate theoretical modeling with empirical analysis to estimate healthcare expenditure differentials associated with HL while accounting for the inability to distinguish treated from untreated HL in the MEPS dataset. Methods: Using the Medical Expenditure Panel Survey (MEPS) Public Use Files, we analyzed healthcare utilization and expenditures for individuals reporting HL. We develop a game-theoretic model in which hearing aid adoption is treated as a social dilemma, capturing private versus social costs. Because hearing aid utilization data were unavailable in this subset, the empirical analysis does not distinguish between treated and untreated HL. Regression models estimated associations between self-reported hearing difficulty and healthcare expenditures while controlling for demographic and socioeconomic characteristics. Results: HL was positively associated with higher healthcare utilization and expenditures across major service categories. Counterfactual predictions based on the weighted regression model suggest substantial expenditure differentials associated with HL. The absence of hearing aid utilization data implies that the analysis cannot directly estimate the potential expenditure reductions associated with treatment adoption. Conclusion: HL represents a substantial public health and economic burden. The theoretical model suggests that low hearing aid adoption may reflect a market failure arising from divergence between private and social incentives. The empirical findings quantify healthcare expenditure differentials associated with HL while acknowledging the limitation that treatment status is not observed. Future research incorporating hearing aid utilization data could provide more precise estimates of the economic implications of treatment adoption
Counterfactual thinking · Health care · Hearing aid · Hearing loss · Medical Expenditure Panel Survey · Panel data · Public health · Socioeconomic status · Hearing Impairment and Communication · Hearing Loss and Rehabilitation · Hearing, Cochlea, Tinnitus, Genetics
| Highly cited | No |
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