Barriers to Hearing Health Care in the U.S. (2018–2023)

Introduction

Hearing loss is a common health issue, yet a large majority of Americans who could benefit from hearing care do not pursue it. An estimated 38 million Americans have some degree of hearing loss, but adoption of hearing interventions (like hearing aids) remains low (New Research Shows 80% of Us Consider Hearing Loss Serious, So Why Do We Ignore It? - Hearing Industries Association). Fewer than 1 in 6 adults (age 20–69) with hearing loss use hearing aids, and even among seniors over 70, only about 30% of those who need hearing aids have ever used them (New Research Shows 80% of Us Consider Hearing Loss Serious, So Why Do We Ignore It? - Hearing Industries Association). In other words, 70–84% of people with treatable hearing difficulties are not currently addressing them. This gap between need and treatment persists despite 80% of Americans recognizing hearing loss as a serious issue (New Research Shows 80% of Us Consider Hearing Loss Serious, So Why Do We Ignore It? - Hearing Industries Association).

Understanding why people avoid or delay hearing health care is crucial. Over the past five years, numerous surveys, consumer studies, and health reports have investigated the reasons behind this reluctance. Common themes have emerged – from financial barriers to social stigma. Below, we summarize the top 10 reasons people do not pursue hearing health, drawing on direct consumer feedback from U.S. studies (2018–2023). We then break down how these barriers vary by age group and demographics, followed by a chart visualizing the findings.

Top 10 Reasons People Avoid Hearing Care

Research consistently shows a mix of practical, financial, and psychological factors that keep individuals from getting hearing tests or using hearing aids. The most-cited barriers include the following:

1. “My hearing isn’t bad enough” (Lack of perceived need) – The number one reason people delay hearing care is that they do not recognize the severity of their hearing loss or feel they can get by without help. In multiple surveys, this came out on top. For example, 56.9% of older adults with diagnosed hearing loss said they can manage without a hearing aid, making this the leading reason for not adopting one (| The Hearing Review). Similarly, a veteran survey found 72.2% declined hearing aids because they felt their hearing was “not bad enough” yet (Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey‐Based Study | CoLab). Many adults – especially in early stages of loss – downplay their hearing difficulty or consider it a normal part of aging rather than a treatable condition (Untreated Hearing Loss in Adults—A Growing National Epidemic). This denial/minimization means they wait years before seeking help. (On average, Americans wait about 6 years from first noticing hearing trouble to getting a hearing test (New Research Shows 80% of Us Consider Hearing Loss Serious, So Why Do We Ignore It? - Hearing Industries Association).)
   
   
2. Cost and financial barriers – The high cost of hearing devices and services is a major deterrent. Modern hearing aids run $1,000–$3,000+ each, and insurance coverage is limited (original Medicare provides no coverage, and only some private plans help with costs). A recent national poll confirmed “too expensive” is the most common reason people don’t wear hearing aids – 56% of respondents cited cost concerns (The Stigma Of Hearing Aids: Hearing Loss Report – Forbes Health). Likewise, over half (55.6%) of U.S. veterans who needed hearing aids reported inability to afford them as a barrier (Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey‐Based Study | CoLab). The financial burden is especially acute for seniors on fixed incomes and lower-income households. Even among those who know they need hearing help, many postpone it due to sticker shock. (One analysis noted cost has long been a primary reason for non-adoption of hearing aids (NIDCD Working Group on Accessible and Affordable Hearing ...).) In short, upfront price and lack of insurance coverage keep millions from pursuing hearing care.
   
   
3. Social stigma and embarrassment – Stigma around hearing loss and hearing aids remains a powerful disincentive, particularly for younger adults. Many people avoid hearing aids for fear of looking “old” or “disabled.” Nearly half of individuals with hearing loss (48%) believe there is still a stigma associated with wearing hearing aids (The Stigma Of Hearing Aids: Hearing Loss Report – Forbes Health). This stigma leads to embarrassment and reluctance to be seen with hearing devices. In one survey of hearing aid non-users, about 14% admitted they felt self-conscious about wearing a hearing aid (ASHA OTC Hearing Aid Survey). The true impact of stigma may be even higher, as some won’t explicitly admit that vanity or pride is a factor. Younger adults in particular report that the idea of needing a hearing aid makes them feel old or embarrassed (A Study of Younger People’s Perceptions of Hearing Care | The Hearing Review) (A Study of Younger People’s Perceptions of Hearing Care | The Hearing Review). This social barrier causes many to delay treatment until they feel they have no other choice.
   
   
4. Doubts about benefit (skepticism that it will help) – Another common reason is the belief that hearing aids or other interventions won’t be effective enough to bother with. Some people think “my hearing is fine in most situations” or “hearing aids don’t work well, especially in noise.” In a study of Hispanic older adults with untreated hearing loss, the second most cited reason (after “not bad enough”) was “hearing aids do not work well/help a great deal,” noted by 13% of respondents ( Self-Reported Reasons for the Non-Use of Hearing Aids Among Hispanic Adults With Hearing Loss - PMC ) ( Self-Reported Reasons for the Non-Use of Hearing Aids Among Hispanic Adults With Hearing Loss - PMC ). Similarly, in a 2023 consumer survey, 36% of those who had stopped using their prescribed hearing aids said poor sound quality or lack of perceived benefit was a major reason (ASHA OTC Hearing Aid Survey). These findings show that low confidence in the efficacy of hearing technology – whether due to outdated perceptions or hearing others’ poor experiences – keeps many on the sidelines. (Indeed, outdated perceptions that hearing aids are bulky and ineffective still persist (MarkeTrak 2022: Navigating the Changing Landscape of Hearing Healthcare | The Hearing Review).) Until people are convinced that hearing treatments will significantly improve their quality of life, they often choose to “live with it” instead.
   
   
5. Discomfort or poor fit – Physical comfort issues and fit problems can deter hearing aid use. Some who try hearing aids end up rejecting them because they feel annoying to wear. Among lapsed users, about 29% reported poor fit or discomfort with the device as a reason for not using it (ASHA OTC Hearing Aid Survey) (ASHA OTC Hearing Aid Survey). Even those who haven’t tried aids may be put off by the idea of having something in their ear all day. In a 2020 senior survey, 10.8% said they found hearing aids uncomfortable (| The Hearing Review). Common complaints include: the earpiece irritates the ear, the device feels heavy or causes headaches, or loud sounds are physically unpleasant. Handling and maintenance hassles (changing batteries, keeping the device clean and dry) also play into this discomfort. If people anticipate that using a hearing device will be physically unpleasant or cumbersome, they are less likely to pursue it in the first place.
   
   
6. Inconvenience and hassle – Beyond physical comfort, there is a perception that addressing hearing loss is inconvenient or too much hassle. This includes the process of getting care (appointments, fittings, follow-ups) and the daily effort of using a device. In a recent survey, 36% of people who chose not to use their prescribed hearing aids said it was because they found them “inconvenient” or a nuisance to manage (ASHA OTC Hearing Aid Survey). Some people don’t want the hassle of wearing and caring for a device all the time. Others simply prioritize other things over making time for hearing care. This sense of inconvenience can also tie into psychological factors – e.g. not wanting to deal with the “hassle” of acknowledging a health problem. Overall, if seeking and using hearing help is seen as too time-consuming, fiddly, or high-maintenance, many will continue to put it off.
   
   
7. Lack of awareness of how to get help – Knowledge gaps about hearing health care are another barrier, especially in communities with less access to information. Some people are unsure where to start or who to consult for hearing issues. For instance, a 2021 survey of U.S. veterans found the most common barrier to seeking hearing care was “uncertainty about who to reach out to,” cited by 42.9% of respondents (Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey‐Based Study | CoLab). If a person doesn’t know whether to see an audiologist, an ENT doctor, or their primary physician – or doesn’t know any providers nearby – they may do nothing. Likewise, many are unaware of newer options (like over-the-counter hearing aids) or hearing assistance technologies. In some cases, lack of information is tied to demographics: surveys have found lower awareness and uptake in certain ethnic groups, partly due to information not reaching them. (In one Hispanic community study, 11% didn’t know where to obtain hearing aids at all ( Self-Reported Reasons for the Non-Use of Hearing Aids Among Hispanic Adults With Hearing Loss - PMC ).) This shows how limited health literacy and outreach around hearing care leaves a segment of the population unserved.
   
   
8. No strong recommendation or referral from a provider – Many people pass routine medical checkups without anyone flagging their hearing loss or referring them to audiology. If a doctor downplays a patient’s hearing complaint (e.g. “it’s just age-related, nothing much to do unless you want hearing aids”) or fails to refer them, the patient is unlikely to act on their own. A survey of older adults diagnosed with hearing loss found 24.5% hadn’t gotten hearing aids because they were never “prescribed” or recommended by the professional (| The Hearing Review). Additionally, 16.7% said their doctor explicitly told them hearing aids were not necessary in their case (| The Hearing Review). This indicates a lack of encouragement from healthcare providers can halt the care pathway. In contrast, when doctors do recommend hearing tests or hearing aids, patients are more likely to pursue them. Unfortunately, hearing loss screening in adults is infrequent, and many providers focus on other ailments. The absence of a medical nudge or prescription means the patient must initiate care themselves – which many won’t do. In short, if healthcare providers don’t raise the issue, patients often let it slide.
   
   
9. Time constraints and other priorities – Life circumstances can cause people to put hearing health on the back burner. Busy adults may find it hard to make time for appointments, especially if they work full-time or care for family members. Among those veterans surveyed, 34.3% said they couldn’t get time off work to address hearing appointments (Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey‐Based Study | CoLab) – a practical barrier for many in the workforce. For others, chronic health issues like diabetes or heart conditions take precedence over “non-life-threatening” issues like hearing loss. People tend to seek care only when communication problems become unbearable. Hearing care is often seen as optional or something that can be “dealt with later.” MarkeTrak industry surveys note that non-adopters often say “the time isn’t right” or they have more pressing priorities than addressing hearing loss (MarkeTrak 2022: Navigating the Changing Landscape of Hearing Healthcare | The Hearing Review). This procrastination is enabled by the typically slow progression of hearing loss – it’s easy to ignore until it severely impacts daily life. Unfortunately, delaying care can worsen social and cognitive outcomes, but in the short term many find it easier to wait until absolutely necessary.

10. Fear and anxiety – Finally, emotional fears stop some people from pursuing hearing care. There can be fear of being diagnosed with a permanent loss, fear of the stigma (as noted), or anxiety about the testing and fitting process. In one study, 28.6% admitted nervousness about seeing a provider as a barrier to seeking hearing care (Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey‐Based Study | CoLab). This anxiety may stem from uncertainty about what will happen at the appointment, or fear of being pressured to buy expensive aids. Some also have a general fear of medical settings or of facing their health problems. Additionally, denial (as mentioned earlier) is a psychological defense – people are afraid to confront the fact that they have hearing loss, so they avoid testing. Older adults might fear the loss of independence associated with needing a hearing device, while younger people fear the change in self-image. In sum, fear of the unknown and the implications of hearing loss can keep individuals in a state of avoidance. It often takes education and reassurance to overcome this barrier.
    
    

(image) Top 10 reasons people avoid hearing health care, based on U.S. surveys in recent years. Lack of perceived need and cost are by far the most prevalent barriers reported. (Percentages indicate roughly how often each reason is cited; data from multiple sources (| The Hearing Review) (Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey‐Based Study | CoLab) (The Stigma Of Hearing Aids: Hearing Loss Report – Forbes Health).) Notably, younger adults tend to emphasize stigma more, whereas older adults more often face financial and access hurdles.

Demographic and Age Group Differences

While the above barriers affect people across the board, different age groups and demographic segments experience hearing health avoidance differently. Below is a breakdown of notable variations:

• Children (0–17 years): For infants and children, the responsibility to pursue hearing care lies with parents and the healthcare system. Thanks to universal newborn hearing screening, most congenital hearing loss is identified early. However, follow-up and intervention can fall through due to access and cost issues. Families face barriers such as the cost of pediatric hearing aids and therapy (even if diagnosis is made) and limited local services, especially in rural areas (Rural Barriers to Early Diagnosis and Treatment of Infant Hearing ...) (New Study Shows Barriers to Healthcare Remain for Children with Hearing Loss and Their Families | The Hearing Review). In a 2014 survey of 1,000 families of children with hearing loss, parents reported high costs, inadequate insurance, and lack of local specialists as significant barriers to care (New Study Shows Barriers to Healthcare Remain for Children with Hearing Loss and Their Families | The Hearing Review). Public school support services also vary, and navigating them can be challenging for parents (New Study Shows Barriers to Healthcare Remain for Children with Hearing Loss and Their Families | The Hearing Review). Unlike adults, children rarely “refuse” hearing care for personal reasons; rather, the issues are access, parental awareness, and resources. Lower-income and rural families may delay getting hearing aids or cochlear implants for a child simply due to financial constraints or travel distance to pediatric audiologists. Improving insurance coverage and early intervention programs (e.g. state Early Hearing Detection and Intervention programs) is key to overcoming these barriers for children.
  
  
• Young Adults (18–40 years): Hearing loss is less common in young adults, but when it does occur (often from noise exposure or genetic conditions), stigma and denial are pronounced in this group. Young adults tend to feel socially invincible, and wearing hearing aids conflicts with their self-image. They are more likely than older folks to say hearing aids are “for old people” and worry about being judged. Consequently, young adults are the least likely to get their hearing tested regularly – one survey found 70% of adults under 40 consider hearing health important, yet only 10% had a hearing test in the past year (A Study of Younger People’s Perceptions of Hearing Care | The Hearing Review). This indicates that even though they conceptually value hearing, most don’t take action, likely due to lack of perceived urgency and stigma. Noise-induced hearing issues (from loud music, etc.) might be written off as temporary ringing. When young people do acknowledge hearing trouble, cost can be a barrier (since they may lack insurance coverage for hearing devices early in their careers), but often vanity and low perceived need override everything else. They may try cheap workarounds (like using earbuds with volume boost) rather than see an audiologist. Awareness campaigns targeting younger demographics (e.g. about safe listening and that hearing aids can be discreet or even “cool” tech) aim to chip away at these attitudes.
  
  
• Middle-Aged Adults (41–64 years): In midlife, hearing loss becomes more common (many start experiencing age-related loss in their 50s and 60s), but this group often postpones care due to busy lifestyles and competing priorities. Career demands can make it hard to take time off for audiology appointments – especially since midlife adults might also be caring for children or aging parents. As a result, many in this bracket delay addressing hearing issues until after retirement. Professional image concerns can also play a role: a 50-year-old in the workplace might worry that wearing hearing aids could bias coworkers or supervisors to see them as “older” or less capable, so they avoid it. At the same time, middle-aged adults are increasingly aware of the health impacts of hearing loss (such as links to cognitive decline and dementia) (Access to Hearing Healthcare and Barriers Among United States ...). This awareness can motivate some to seek treatment earlier. In terms of barriers, cost is significant here as well – many private insurance plans do not cover hearing aids for adults, and this age group isn’t yet eligible for senior programs. Thus, a 55-year-old with mild loss might wait, planning to address it at 65+ when Medicare (hopefully) might help or when the loss worsens. There’s also a sentiment of “I’m not old yet” denial in this group, similar to younger adults, which feeds into procrastination and stigma. Encouraging midlife adults to include hearing tests in their routine health checkups (as they do with vision or cholesterol checks) is an ongoing challenge.
  
  
• Older Adults (65+ years): Seniors have the highest rates of hearing loss – roughly one-third of 65–74 year-olds and over half of those 75+ have measurable hearing impairment (Untreated Hearing Loss in Adults—A Growing National Epidemic). Yet a large portion do not use hearing aids or other hearing services. For this age group, cost is often the number-one barrier, because Medicare does not cover hearing aids and out-of-pocket costs are high. Many retirees live on limited income and may forego hearing aids as a result. Another big factor is the attitude that “hearing loss just comes with age.” Older adults often accept poor hearing as normal and may not seek care unless family pushes them. In fact, it’s commonly the spouse or adult children who convince a senior to get a hearing test. Those without a strong support network might never pursue it (lack of social support was identified as a contributor to non-use in studies) ( Factors Impacting the Use or Rejection of Hearing Aids—A Systematic Review and Meta-Analysis - PMC ). On the flip side, stigma tends to diminish somewhat among seniors – needing a hearing aid is more socially acceptable at 75 than at 45. But pride can still be an issue; some elders refuse aids saying “I don’t want to be seen as an invalid.” Additionally, practical access issues can impede seniors: mobility or transportation challenges can prevent them from visiting audiology clinics, and some rural seniors have limited nearby providers. There are also racial and ethnic disparities in senior hearing care. For example, Black older Americans report lower rates of hearing aid use than White Americans (MarkeTrak 2022: Navigating the Changing Landscape of Hearing Healthcare | The Hearing Review), and studies in Latino communities (like the El Paso study) show very low uptake linked to awareness and cost barriers ( Self-Reported Reasons for the Non-Use of Hearing Aids Among Hispanic Adults With Hearing Loss - PMC ). Culturally appropriate outreach and accessible services are needed to close these gaps. In summary, for most seniors who avoid hearing care, it comes down to affordability, perceived need, and access. Once those are addressed (e.g. via more affordable over-the-counter hearing aids and mobile clinics), many are willing to try hearing solutions, as evidenced by the rising adoption rates in the 70+ group in recent years.
  
  

Conclusion

Over the past five years, research has painted a consistent picture of why so many Americans ignore their hearing health. The top 10 reasons can be summed up as a mix of denial (“I hear well enough”), cost, stigma, lack of information, and practical hurdles. These barriers often interact – for instance, someone might downplay their hearing loss (denial) until a tipping point, at which time cost or lack of access becomes the next obstacle. Breaking through these barriers will likely require multi-pronged efforts:

• Education to improve awareness that hearing loss is treatable and to reduce stigma (making hearing care as routine as eye care).
  
  
• Accessible services and funding, such as affordable hearing devices (the advent of OTC hearing aids is one step) and insurance coverage or subsidies for those in need.
  
  
• Proactive healthcare screening and referrals, so that individuals get a gentle push from trusted providers before their quality of life suffers.
  
  
• Support networks – involvement of family, consumer support groups, and community programs to encourage individuals to take action on hearing issues.
  
  

By addressing the reasons people avoid hearing care, stakeholders hope to narrow the gap between those 38 million Americans with hearing trouble and the relatively small fraction currently getting help. The past five years have seen improvements (e.g. slight uptick in adoption rates (MarkeTrak 2022: Navigating the Changing Landscape of Hearing Healthcare | The Hearing Review)), but there is still much work to do. Empowering consumers with knowledge, affordable options, and social support will be key to overcoming the top 10 barriers and ensuring hearing health is pursued across all ages and demographics.

Sources: Recent surveys and studies on hearing health behaviors and barriers, including MarkeTrak 10 & 2022 reports () (MarkeTrak 2022: Navigating the Changing Landscape of Hearing Healthcare | The Hearing Review), a 2020 SeniorLiving.org survey of older adults (| The Hearing Review), Forbes Health hearing loss stigma survey (The Stigma Of Hearing Aids: Hearing Loss Report – Forbes Health) (The Stigma Of Hearing Aids: Hearing Loss Report – Forbes Health), an NIH-supported veteran hearing healthcare survey (2025) (Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey‐Based Study | CoLab), academic studies on non-use of hearing aids in Hispanic communities ( Self-Reported Reasons for the Non-Use of Hearing Aids Among Hispanic Adults With Hearing Loss - PMC ), the ASHA 2023 OTC Hearing Aid Survey (ASHA OTC Hearing Aid Survey), and data from NIDCD and CDC on hearing loss prevalence and treatment uptake (New Research Shows 80% of Us Consider Hearing Loss Serious, So Why Do We Ignore It? - Hearing Industries Association) (MarkeTrak 2022: Navigating the Changing Landscape of Hearing Healthcare | The Hearing Review). Each offers direct insights from consumers about why hearing help is avoided, as summarized above.