Individual Life-Course Socioeconomic Position and Hearing Aid Use in the Atherosclerosis Risk in Communities Study

Background To measure the association between individual life-course socioeconomic position (SEP) and hearing aid use, we examined childhood and adulthood socioeconomic variables collected at the Atherosclerosis Risk in Communities (ARIC) study baseline visit (1987–1989)/Life Course Socioeconomic Status study (2001–2002) and hearing aid use data collected at visit 6 (2016–2017). Methods ARIC is a prospective cohort study of older adults (45–64 years) recruited from 4 U.S. communities. This analysis included a subset of 2 470 participants with hearing loss at visit 6 (≥25 decibels hearing level [dB HL] better-ear) with complete hearing aid use data. Childhood SEP variables included parental education, parental occupation, and parental home ownership. Young and older adulthood SEP variables included income, education, occupation, and home ownership. Each life epoch was assigned a score ranging from 0 to 5 and then summed to calculate the individual cumulative SEP score. Multivariable-adjusted logistic regression was used to estimate the association between individual cumulative SEP and hearing aid use. Missing SEP scores were imputed for participants with incomplete socioeconomic data. Results Of the 2 470 participants in the analytic cohort (median [interquartile interval] age 79.9 [76.7–84.0], 1 330 [53.8%] women, 450 [18.2%] Black), 685 (27.7%) participants reported hearing aid use. Higher cumulative SEP was positively associated with hearing aid use (odds ratio [OR] = 1.09, 95% confidence interval [CI]: 1.04–1.14), and slightly stronger for childhood (OR = 1.09, 95% CI: 1.00–1.20) than older adulthood SEP score (OR = 1.06, 95% CI: 0.95–1.18). Conclusions In this community-based cohort of older adults with hearing loss, higher individual life-course SEP was positively associated with hearing aid use.