Objectives: Research from Europe and the USA suggest higher rates of hearing loss among children from diverse racial or ethnic backgrounds, but there is a lack of data in the Australian context. About one in four Australians has a diverse cultural and linguistic background, so there is a compelling need to investigate inequalities in hearing among Australian children from these communities and the factors that contribute to any inequalities. Objectives of this study were (1) to examine the prevalence of hearing loss in children from culturally and linguistically diverse versus majority backgrounds, and (2) to examine the demographic, socioeconomic, health, and migration-related factors associated with hearing loss in children from diverse cultural and linguistic communities.
Design: A population-based cross-sectional dataset of 11- to 12-year-old children, collected in 2015 from the Child Health Checkpoint sub-set of the Longitudinal Study of Australian Children was analyzed. Children from diverse cultural and linguistic communities were identified based on primary caregivers speaking a language other than English at home. A total of 145 children from diverse cultural and linguistic backgrounds and 1324 children from ethnic majority background who completed pure-tone audiometry were included in the analysis. Logistic regression was used to estimate correlates of hearing loss.
Results: A higher prevalence of any hearing loss (>15 dB HL in either ear) was found in children from diverse cultural and linguistic (38.3%) compared with ethnic majority (21.1%) communities. Of the 49 children from culturally and linguistically diverse backgrounds with hearing loss, 58.0% had unilateral hearing loss. Most hearing loss (85.7%) was slight (16 to 25 dB HL). After adjusting for sociodemographic factors, family history of hearing loss, and presence of ear infections, children from diverse cultural and linguistic communities had 58% higher odds of hearing loss compared to their ethnic majority counterparts (odds ratio [OR], 1.58: 95% confidence interval [CI], 1.01-2.46). Primary caregiver self-reported lower English language proficiency (OR, 3.54; 95% CI, 1.58-7.92) was associated with higher likelihood of hearing loss, while longer duration of residence in Australia was associated with reduced odds of hearing loss (OR, 0.97; 95% CI, 0.94-0.99) among children from diverse cultural and linguistic backgrounds.
Conclusions: Hearing loss was more common among children from culturally and linguistically diverse families compared with their ethnic majority peers. Future research should focus on identifying causal factors to inform hearing loss prevention strategies, and systematic screening for hearing loss targeting diverse cultural and linguistic communities to address hearing health inequalities.
Keywords: Culturally and linguistically diverse; Hearing health inequalities; Pediatric hearing loss.
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