Foundational Approaches to Advancing Hearing Health Equity: A Primer in Social Epidemiology

Abstract

Hearing health is inextricably linked to factors beyond biology. Social, demographic, environmental, geographic, and historical influences affect hearing health, but these factors are often unmeasured within traditional biological, clinical, and epidemiological studies of hearing health. With increasing recognition of hearing health over the life course as a public health priority, there is also a growing understanding of existing hearing health inequities at the individual, community, national, and global levels. To make progress in addressing these inequities, public health disciplines, such as social epidemiology, can provide valuable frameworks. With a focus on integrating the biological and functional with social and structural factors influencing health, social epidemiology provides key concepts and approaches for filling existing research and practice gaps. In this review, we introduce the discipline of social epidemiology and its associated concepts to inspire greater cross-disciplinary collaboration for the ultimate goal of advancing hearing health equity.

Figure 1.

Embodiment of social structural factors affecting individual functional development and biological processes.

Figure 2.

A Simplified Framework of the Influences & Opportunities for Intervention to Support Hearing Health Adapted from: Braveman, P. A., Egerter, S. A., & Mockenhaupt, R. E. (2011). Broadening the focus: the need to address the social determinants of health. American journal of preventive medicine, 40(1), S4-S18.

Figure 3.

Proposed social epidemiologic framework of factors driving hearing health outcomes. Adapted from: Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From social integration to health: Durkheim in the new millennium. Social Science and Medicine, 51, 843–857.