A range of policies and regulations (Box 1) can affect how different stakeholder groups collaborate within the hearing health sector (Box 2) to provide information, services and interventions for consumers with hearing loss. Access to innovations should be promoted alongside the strengthening of existing systems and establishment of new independent systems to assess and protect the integrity of data8,22, as well as launching initiatives on transparency of research and education that can be used to inform clinical recommendations, and allocate funding for hearing services and products.
Hearing devices are currently regulated primarily in terms of professional practices, product safety and efficacy, and within the context of competition law. Because of the data collection capabilities of new digital hearing products, regulation should also consider data collection, integrity, access and user privacy8,22. Device developers, providers and healthcare professionals should focus on furthering health and health equity, which will require attention to power imbalances and structural inequities. Longitudinal studies will be needed to assess the effects of the changes in the hearing health sector on consumer experience, professional roles and clinical service availability across countries with different structural regulations.
Consumer education and support to access hearing services and products will be especially important for people who may be more vulnerable to misleading marketing claims15,23 because of limited digital, health or research literacy. More than 65% of adults aged over 60 have hearing loss, with clear increases in prevalence with every decade of age1. Hearing loss is associated with higher risks of dementia and cognitive impairment1 and deaf and hard-of-hearing people are more likely to experience communication challenges that limit their access to information24. Vulnerable groups, including poorer populations, are less likely to access new technologies than less vulnerable groups, and this may contribute to decreased health equity25. Hearing loss is also associated with common illnesses such as hypertension and diabetes1, and with an increased risk of hospitalization and mortality26. Adults with hearing loss are therefore overly represented among patients who receive other health and disability services.
Professional education is required across health and disability sectors to support the communication and safety needs of patients with hearing loss24. This will particularly benefit patients who do not receive any hearing care and those who may access direct-to-consumer hearing devices without the services of a hearing health professional such as an audiologist or an otologist. Empowering a broad range of professionals to better support the needs of people with hearing loss could improve engagement and satisfaction with healthcare in general24. This could also increase opportunities for adults with hearing loss to receive information and advice that is independent from product sales.
Everyone with hearing loss should have access to reliable and complete information and to independent professional advice when selecting safe, evidence-based and cost-effective hearing and communication support1. Tectonic shifts in the landscape of the hearing device and hearing service industries may pose a critical threat to achieving this goal, as well as providing fresh opportunities. Further research is needed on conflicts of interest, gaps in regulation, and the rapid expansion of emerging technologies if the benefits of these innovations are to be realized by all.