Future Leaders Award Winner 2024: Emily Barrett

Shining a Light: Funding for Hearing Aids in Nova Scotia

By: Emily Barrett, ~5 minute read

Do you know the facts on hearing loss and hearing aid funding in Canada? According to Statistics Canada, approximately 37% of Canadian adults have hearing loss¹. Did you know that individuals with hearing loss typically wait between 7 to 10 years before receiving hearing aids²? You may be wondering why someone would wait so long to receive help, and one of the main reasons is finances³. This makes sense, as Nova Scotia had the highest provincial poverty rate in Canada, with 1 in 10 individuals living beneath the poverty line^{4, 5}. Nova Scotia also had the second highest poverty rate in Canada for the population of adults aged 65 years and older in 2020⁴. This is major! No wonder Dalhousie’s “Hear@Dal” program, which aims to provide individuals over the age of 65 with free hearing aids, is consistently full and cannot accept any new clients⁶. In short, we desperately need solutions, such as provincial hearing aid funding to help these individuals. This is supported by the findings of a consumer survey done in 2022, which found that individuals were more motivated to receive hearing aids with increased 3rd party funding as opposed to cheaper hearing aids³. This is where the call for hearing aid funding in Nova Scotia comes from, especially because this funding would benefit individuals as well as Nova Scotia’s economy. 

For an individual, untreated hearing loss can result in higher rates of depression, anxiety, and social isolation, which further contribute to a lower quality of life⁷. Untreated hearing loss has also been linked to dementia, with a higher prevalence of dementia as hearing loss increases in severity⁸. These negative impacts can be reduced through hearing aids. By wearing hearing aids, individuals can begin to socialize and participate in their life. This leads to better mental health, including decreased overall anxiety and depression⁹. Moreover, research has found that individuals with hearing loss who are at higher risk of developing dementia can slow their cognitive decline by wearing hearing aids¹⁰. Overall, treating hearing loss can have not only individual benefits but can also have benefits that are far more widespread, such as benefits provided to the community and to the economy. 

Nova Scotia’s economy would also benefit from providing hearing aid funding, through decreased overall healthcare costs by spending healthcare money on preventative measures and through increasing the workforce. As you may have heard, older individuals with untreated hearing loss are at a much higher risk of falling, with mild hearing losses tripling the risk of a fall occurring¹¹. However, did you know that the risk of falls increases specifically by 140% for every increase of 10 decibels of hearing loss¹¹? This data is very important to consider, as falls in the senior population cost the Canadian healthcare system a total of $5.6 billion in 2018¹². Falls in the same population in Atlantic Canada cost the healthcare system $464 million in 2018¹³. In addition, falls in the general population was the leading cause of injury deaths in Atlantic Canada in 2018¹³. Our healthcare system also needs to consider that untreated hearing loss actually increases an individual’s risk of hospitalization as well as readmission over a 10-year period following hospitalization^{14, 15}. This is why preventative healthcare is so important, especially considering that consistent hearing aid users reduce their risk of falling by 50%¹⁶. Introducing hearing aid funding would result in seniors reducing their risk of falls and would therefore result in lower overall healthcare costs.

Finally, aiding individuals would increase the number of Nova Scotians who are able to work, as untreated hearing loss can be a barrier to obtaining work. In a study completed by the Better Hearing Institute, it was found that untreated hearing loss impacts one’s household income, equaling an approximate loss of $12,000 USD of annual income depending on the severity of hearing loss¹⁷. Moreover, this loss of annual income can be reduced by 50% through treatment using hearing aids¹⁷. Treating hearing loss may mean that individuals may be able to delay retirement from the workforce, resulting in higher incomes in those with hearing loss, which is money that can be put back into Nova Scotia’s economy.

Other provinces, such as Ontario, have programs that provide funding for hearing aids. What is great about Ontario’s assistive devices program (ADP) is that they do not provide funding solely based on age requirements¹⁸. Hearing loss can happen at any point in life, and the unfortunate aspect is that many individuals with hearing loss grow out of the government services provided to them. What happens when these individuals continue their education in university or as a young adult in the world who does not have insurance that covers hearing aids? By providing a program like Ontario’s ADP program, Nova Scotia would be able to help out individuals of all ages with hearing loss. As previously discussed, this can mean that we increase the number of individuals in the workforce and help bring more income to individuals with hearing loss.

Currently, there is a bill that has been introduced through a first reading to the legislative assembly of Nova Scotia, titled the “Affordable Hearing Aids for Seniors Act”, or “Bill No. 287”¹⁹. The goal of this act would provide funding for hearing aids for individuals who are over the age of 65 and have a long-term hearing loss¹⁹. This bill has not gone onto a second reading just yet; however, it will be very interesting to see what other requirements they consider are necessary to receive funding. After the second reading occurs, it will be referred to a committee, and if anyone is interested in this bill and wants to be at a hearing to represent the bill should reach out to the Legislative Counsel’s Office so they can attend the hearing²⁰.

Provincial hearing aid funding would assist many Nova Scotians who have hearing loss, and it would be money well spent by the government. Providing access to hearing technology would allow individuals to improve their health, both mental and physical, and would result in lower healthcare costs and hospitalizations. Other provinces have demonstrated how to successfully implement provincial hearing aid funding, and now it seems that Nova Scotia may be on the brink of introducing a new bill in support of this. However, there is still work to be done, as hearing loss can happen at any age. Hopefully, Bill 287 gets passed, which then opens the door for further discussion on hearing aid funding for more Nova Scotians. In the meantime, we will have to continue advocating for change.

References

1. Statistics Canada. (2022, March 3). World hearing day. https://www.statcan.gc.ca/o1/en/plus/476-world-hearing-day
2. Simpson, A. N., Matthews, L. J., Cassarly, C., & Dubno, J. R. (2019). Time From Hearing Aid Candidacy to Hearing Aid Adoption: A Longitudinal Cohort Study. Ear and Hearing, 40(3), 468–476. https://doi.org/10.1097/AUD.0000000000000641
3. Windmill, I. M. (2022). The Financing of Hearing Care: What We Can Learn from MarkeTrak 2022. Seminars in Hearing, 43(4), 339–347. https://doi.org/10.1055/s-0042-1758400
4. Canadian income survey: Poverty, 2022. (2024, April 26). Finance and Treasury Board. https://novascotia.ca/finance/statistics/topic_news.asp?id=19865&fto=23w&rdval=2024-04
5. King, M., Cooke, A. (2024, January 24). Quite dire: N.S. has the highest poverty rate in Canada, says new report. Global News. https://globalnews.ca/news/10247945/united-way-report-poverty-ns-halifax/
6. Harris, S. Overwhelmed by demand, Dal hearing aid program for seniors can’t see new clients. CBC News. https://www.cbc.ca/news/canada/nova-scotia/dalhousie-hearing-aid-program-demand-1.6994925
7. Arlinger, S. (2003). Negative consequences of uncorrected hearing loss—A review. International Journal of Audiology, 42 Suppl 2, 2S17-20.
8. Huang, A. R., Jiang, K., Lin, F. R., Deal, J. A., & Reed, N. S. (2023). Hearing Loss and Dementia Prevalence in Older Adults in the US. JAMA, 329(2), 171–173. https://doi.org/10.1001/jama.2022.20954
9. (https://entsaofappleton.com/audiologist/benefits-of-hearing-aids/).
10. Lin, F. R., Pike, J. R., Albert, M. S., Arnold, M., Burgard, S., Chisolm, T., Couper, D., Deal, J. A., Goman, A. M., Glynn, N. W., Gmelin, T., Gravens-Mueller, L., Hayden, K. M., Huang, A. R., Knopman, D., Mitchell, C. M., Mosley, T., Pankow, J. S., Reed, N. S., … Coresh, J. (2023). Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): A multicentre, randomised controlled trial. The Lancet, 402(10404), 786–797. https://doi.org/10.1016/S0140-6736(23)01406-X
11. Lin, F. R., & Ferrucci, L. (2012). Hearing Loss and Falls Among Older Adults in the United States. Archives of Internal Medicine, 172(4), 369–371. https://doi.org/10.1001/archinternmed.2011.728
12. Parachute. (2021, July 5). The cost of injury in Canada 2021. https://parachute.ca/en/professional-resource/cost-of-injury-in-canada/
13. British Columbia Injury Research and Prevention Unit. (n.d.). Cost of injury in Atlantic Canada. Cost of injury. https://www.costofinjury.ca/ap/en/cost-of-injury-in-atlantic-canada
14. Reed, N. S., Altan, A., Deal, J. A., Yeh, C., Kravetz, A. D., Wallhagen, M., & Lin, F. R. (2019). Trends in Health Care Costs and Utilization Associated With Untreated Hearing Loss Over 10 Years. JAMA Otolaryngology–Head & Neck Surgery, 145(1), 27–34. https://doi.org/10.1001/jamaoto.2018.2875
15. Thai, A., Khan, S. I., Choi, J., Ma, Y., & Megwalu, U. C. (2022). Associations of Hearing Loss Severity and Hearing Aid Use With Hospitalization Among Older US Adults. JAMA Otolaryngology–Head & Neck Surgery, 148(11), 1005–1012. https://doi.org/10.1001/jamaoto.2022.2399
16. Campos, L., Prochazka, A., Anderson, M., Kaizer, A., Foster, C., & Hullar, T. (2023). Consistent hearing aid use is associated with lower fall prevalence and risk in older adults with hearing loss. Journal of the American Geriatrics Society, 71(10), 3163–3171. https://doi.org/10.1111/jgs.18461
17. Better Hearing Institute. (2007). The impact of untreated hearing loss on household income. https://betterhearing.org/HIA/assets/File/public/marketrak/MarkeTrak_VII_The_Impact_of_Untreated_Hearing_Loss_on_Household_Income.pdf
18. Ontario. (2016, December 7). Assistive Devices Program. Retrieved April 27, 2022, from https://www.ontario.ca/page/assistive-devices-program
19. Bill 287: Affordable Hearing Aids for Seniors Act. (2023). 1^st Reading Mar. 30, 2023, 1^st session, 64^th General Assembly. Retrieved from the Nova Scotia Legislature website: https://nslegislature.ca/legc/bills/64th_1st/1st_read/b287.htm
20. Nova Scotia Legislature. (n.d). How a bill becomes law. https://nslegislature.ca/about/how-legislature-works/how-bills-become-law