Dr. Ross on Hearing Loss
The Effects of an Untreated Hearing Loss on Workplace Compension
by Mark Ross, Ph.D.
It has long been recognized that a hearing loss can have a pervasive and profound impact on the lives of both the affected individual and his or her family. In addition to making oral communication interactions more challenging, a hearing loss can also impact upon such diverse dimensions of the human condition as mental, emotional and physical well being, social skills, self-esteem, family relationships, as well as work and school performance. While not as obvious as communication problems, research studies and personal experiences over the years have amply demonstrated these other possible consequences of a hearing loss. We also know that many of these problems can be ameliorated with personal amplification – hearing aids and/or cochlear implants. This was convincingly demonstrated a few years ago in a classic study involving thousands of people commissioned by the National Council on the Aging. The study showed that people with treated hearing loss (i.e. hearing aids) were less socially isolated and more emotionally secure than a comparable group with untreated hearing losses. Furthermore, these positive effects were not only felt by the person with a hearing loss, but were also apparent to family members while easing family tensions - demonstrating once again that a hearing loss is truly a family affair.
In addition to its effect on psychosocial status and interpersonal communication, a hearing loss may also influence a person’s employment status. Most jobs in our society require some degree of interactive verbal communication; one must be able to communicate effectively with co-workers, the public, and most important, one’s supervisors. Any hindrance in that ability may interfere with the efficiency and accuracy of these communication exchanges and thus affect how well a job is performed. And this, in turn, may well influence the compensation that a person receives for the job he or she is doing. It can, for example, help determine how much people with a hearing loss are paid for a job or, indeed, whether they have a job at all. While there has been much written on this overall topic over the years – we already know, for example, that deaf people are too often underemployed and underpaid – but because of changing technology, social attitudes, and public law the situation is ever evolving. It is helpful, therefore, to systematically update our information on the topic. Most importantly, it is necessary to determine if the use of amplification can mitigate the consequences of a hearing loss in the workplace. In a recent publication, Sergei Kochkin, Executive Director of the Better Hearing Institute, addressed this question.
Before proceeding, it is worth noting that this study focused on people currently in the work force. This refutes the common stereotype that hearing loss only affects the elderly, or those whose working days are long behind them. In point of fact, fully 60% of the people with hearing loss are either in the work force or in educational settings. The study’s findings, therefore, are relevant to the majority of people with hearing loss who are presently employed, or who will soon be looking for a job (good luck!). The study examined the workplace compensation of three groups of people, those wearing aids (about 1800 of them), those with hearing losses (about 3000) but who were unamplified, and a large cohort of normally hearing people as controls. To ease the analysis, the respondents with hearing loss were broken into ten groups (termed deciles) depending upon severity of hearing loss. Great care was taken to ensure a representative demographic sample from all areas of the country. Thus, the results present the best and most current knowledge we have regarding the economic status of people with hearing loss in the workforce.
One basic finding of the survey was the not unexpected observation that employment income is related to the degree of hearing loss. While the people with the mildest hearing losses show little or no drop in income compared to their normal hearing peers, as the hearing loss increases, so does the reduction in compensation.. This decline is the most rapid and most apparent for the groups with the more severe hearing losses. The income level of the worst group (the tenth decile) was about $14,000 less than those earned by the group with the mildest hearing losses. This figure does not consider whether or not the person used hearing aids, just the effects of the hearing loss itself was taken into account. For an “invisible” handicap, it’s clear that a hearing loss can have some very “visible” consequences.
The key question in this study, however, was whether this effect can be ameliorated with amplification. The short answer is a resounding “yes” – ameliorated, but not completely overcome. The study compared the salary differential by degree of hearing loss for both the aided and unaided groups compared to those with normal hearing. The results clearly demonstrate the economic advantages of a person with a hearing loss in using amplification on the job. While no advantage of amplification is seen for the decile with the mildest hearing loss, as the hearing loss increased so does the income gap between the groups. This gap between the groups widens with increasing hearing loss. Finally, for the group with the most severe hearing losses (10% of the total), the income differential between the aided and unaided groups reaches the rather astounding figure of $31,000 a year! This is how much less people with the most severe unaided hearing loss make compared to a comparable group of hearing aid users. This is clearly an horrendous and discouraging figure. But even for hearing aid users, it’s not as if the hearing loss has no effect. The results indicate that even with amplification, the group with the most severe hearing losses (10% of the total) still earns about $11, 000 less than their normal hearing peers. In other words, while the gap can be narrowed with hearing aids, it was not completely overcome.
What we have learned so far is that a hearing loss has economic consequences, but that a hearing aid can ameliorate, but not completely overcome, these consequences. This is hardly a surprise, though one that is important to document as this study has. We’ve always known that a hearing aid does not replace normal hearing. Indeed, one of the myths we’ve had to confront over the years, probably from the time the first electronic hearing aid was used, was the myth that a hearing aid would “correct” a hearing loss in a somewhat comparable way that eyeglasses corrects visual problems. Unfortunately, it just isn’t so. Particularly for the people with the most severe hearing loss, residual listening problems are still manifested in some circumstances. In short, a hearing aid is an aid – and one to be grateful for – but it is not a replacement normal ear.
The survey asked the respondents a number of additional questions regarding their experiences in the workplace. These questions concerned such topics as their perception of compensation compared to their normal hearing peers of comparable training and education and whether they feel they have been passed over for a promotion because of their hearing loss. It turns out that only in the middle age unaided group (ages 45-64) did the respondents feel that they were being treated differently than their normal hearing peers (specifically regarding compensation equity). This was not the case for those people of the same age group who wore hearing aids, offering additional evidence that hearing aids do help. We should keep in mind that these are general conclusions; anecdotally, we know of many individual exceptions.
In terms of employment status, the survey found that the unaided groups were unemployed at a higher rate than their aided peers, and that in agreement with other results from the study, the disparity in employment status increased as the hearing loss became more severe. Unfortunately, this result does accord with numerous observations formed over the years; it does seem clear that people with severe hearing loss have extra difficulty in finding (but not necessarily holding) a job.
It should not be concluded from the forgoing, however, that hearing aids are some sort of magic pill, a panacea that will produce full employment equity with people with normal hearing. They are simply the first step, but a crucial one. If somebody with more than a mild hearing loss denies him or herself the potential benefits of personal amplification on the job, then as we have seen their wage status will likely be less than their aided peers. But as crucial as personal amplification is, it is often not enough. A particular job or function may make communication demands that exceed the capabilities of conventional hearing aids. Other forms of hearing assistive technologies (HAT) are often needed to meet this challenge.
Each workplace makes its own communication demands, and these may be different for each person, with or without a hearing loss. Thus, the first step in selecting what specific hearing assistive technology can be helpful is analyzing the nature of the communication interactions on the job, and to isolate those that are proving difficult for the person with the hearing loss. Solutions can only follow an accurate analysis of the problems. Such solutions can vary from something as simple as moving a desk away from a noisy hallway, to reversing one’s desk to keep the sun out of one’s eyes. One major challenge confronting hearing impaired people on the job is the need to communicate effectively on the telephone. Fortunately, in this and for many other job requirements, there are hearing assistive technologies that can be brought to bear. Help is available, but must be actively sought. An Audiologist can be helpful in isolating specific job related hearing needs and in identifying specific devices for specific needs. In many states, Vocational Rehabilitation offices, or State Commissions of the Deaf and Hard of Hearing can help people with hearing loss in securing such devices. But this kind of outcome just doesn’t happen because there is a need; on the contrary, it is the involved individuals who have to take the lead. In this, as in so many other areas concerning hearing loss, passivity is not an option. But the first step, as this article by Kochkin demonstrates is for the person with a hearing loss to acquire and use hearing aids.