Hearing Loss Is on the Rise. A New Wave of Tech Might Help

Between pounding jackhammers and screeching machinery, the cacophony of a construction site is unpleasant to most. Not to Christine, an 18-year-old from Alabama. After getting her first pair of hearing aids, Christine found the noises profound.

"It was surprising to stop and hear what things actually sound like to other people," she said. "I sat down beside a construction site just to hear the different noises. I like to listen to the machines running. My favorite is the 18-wheelers driving around the site. 

"The rumble sounds better than before." 

Christine struggled to hear out of her left ear for her whole life. In March, she was prescribed her first pair of hearing aids. In addition to dramatically improving her hearing, they also notably improved her balance. 

Christine is one of the 38 million Americans who have some degree of hearing loss. Hers was genetic, but many more are put at risk by exposure to loud noises. The World Health Organization estimates that over a billion young adults are at risk of hearing loss "due to unsafe listening practices." 

Though hearing loss is widespread, the adoption of hearing aids is not. An estimated 13% of people aged 45 to 64 would benefit from hearing aids, according to a 2019 study, yet just over 2% actually get them. 

Some of that has to do with cost. Prescription hearing aids typically start at $1,000 and can run up to $4,000. About a third of that covers the price of the actual hearing aids, said Barbara Kelley, executive director of the Hearing Loss Association of America (HLAA). The rest of the amount covers hearing tests, device fitting and return visits to the audiologist, which are crucial services for those with severe hearing loss. 

But that might change soon. The Food and Drug Administration last year allowed for the sale of over-the-counter hearing aids for people with mild to moderate hearing loss. Many OTC hearing aids run below $999, and prices are expected to fall as competition grows stiffer. The hope is that by making hearing aids cheaper and easier to buy, more people who need them will get access. 

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"Hearing health is a primary health concern. It's just like knowing your blood pressure or your weight, because hearing loss is linked to quality of life," Kelley said. "If we can get more people taking that first step sooner rather than waiting five to seven years after they find out they have hearing loss, that's a good thing." 

New market, new brands

Making hearing aids cheaper and more accessible is a strong first step. But there are other barriers that stop people from getting the hearing help they need, says Kevin Franck, former head of audiology at Harvard Medical School's Otolaryngology department. 

"There are countries where [hearing aids] are fully reimbursed and free to the patient, and still a fraction of the people who need them get them," said Franck, who's also chair of the HLAA's board. "It doesn't mean cost is not a factor, but it's not the only factor."

Another factor is stigma. Hearing aids are associated with aging, and many people would rather have difficulty with their hearing than conspicuously use hearing aids. While this stigma persists to this day, both Kelley and Franck say it seems to be diminishing among youth. Younger generations are used to wearing earbuds regularly, making the leap to hearing aids less daunting. 

The bigger issue, says Franck, is that hearing aids can't entirely cure hearing loss. Prescription glasses or contacts can recover a person's vision, but hearing aids don't work in the same way. (For that reason, Franck is big on preventative measures -- like buying noise-canceling headphones so you don't have to crank the volume up to drown out nearby sounds.) Once enough sensory cells within the ear are destroyed, there will always be some level of distortion, even with a perfectly fitted pair of hearing aids. 

That's been the experience of Catie, who's in her 20s. "My experience with them so far has been mostly ups, but a few downs," she said. "I hear too much background noise ... it's sometimes hard to focus.

"They take a long time to get used to," she added. "That can take about six months to a year."

Since the FDA permitted the sale of OTC hearing aids in late 2022, consumer technology brands like Sony and Jabra have hit the market. So far, their efforts involve white labeling -- taking hearing aid products made by medical companies and rebranding them. Jabra's Enhance Select hearing aids were formerly Lively, a connected health care company bought by hearing aid manufacturer GN in late 2021.

The brand recognition of Sony, Jabra or Bose may provide some comfort to hearing aid novices, Kelley said. 

But the real impact, Franck says, will be once these companies create products from the ground up, forcing hearing aid manufacturers to compete. 

According to Franck, Apple has been approaching the capabilities of hearing-aid chips in its consumer market. To develop spatial audio, an AirPod Pro feature that re-creates surround sound, the tech giant needed a deep understanding of the shape of the ear. And to create the Transparency noise-canceling mode on AirPods Pro, Franck added, Apple needed sophisticated feedback mitigation. 

So even though Apple doesn't make hearing aids, the company could be the biggest disruptor to the OTC market because it wants to do just about everything else. "Companies like Apple are figuring out how to do all that and more, and don't carry the stigma of the hearing aid," Franck said. 

In fact, the AirPods Pro can practically be used as hearing aids. If you download an app that tests your hearing, that data can be input into an iPhone's Health app and then used to tweak the AirPod Pro's settings on Transparency Mode, using the device's microphones to amplify the appropriate sounds. Apple doesn't make a big deal of it, Franck says, because that could lead the FDA to classify the AirPods Pro as a Class II Medical Device, which would subject the product to regulations. 

Accessing hearing help

Catie says her prescription hearing aids would have cost $12,000 had insurance not covered them. About 26 million Americans, 8% of the population, lack health insurance. Catie is encouraged by the advent of OTC hearing aids and hopes they'll soon be available more widely.

"It would be awesome for them to be more accessible for everyone," she said. "Mine were so hard to get."

At the moment, OTC hearing aids are only for people with mild to moderate hearing loss. More severe cases will still need a prescription. Consultations with audiologists are needed, Franck said, to make sure hearing aids are properly molded to the ear and to ensure severe hearing loss may not better be addressed by a cochlear implant. 

"We need to walk before we can run," Franck said. "My hope is that this is where we start and we make progress from there." 

More on hearing aids

• Are Over-the-Counter Hearing Aids Just as Good? 
• Everything to Know About Buying Over-the-Counter Hearing Aids 
• Which Hearing Aid Is Right for You? 
• How to Know if You're a Good Candidate for OTC Hearing Aids 

Correction, May 22: The Lively bought by Best Buy 2018 is unrelated to the Lively products that were rebranded as Jabra Enhance Select.