Racial Disparities in Pediatric Sensorineural Hearing Loss Diagnoses and Cochlear Implantation

Introduction: Sensorineural hearing loss (SNHL) impacts 2.5 out of every 1,000 children born in the US. This study investigates racial differences in newborn hearing screening (NHS) failures, subsequent SNHL diagnosis, and cochlear implantation in the US.

Methods: A retrospective study utilizing the TriNetX global health research network database was conducted on patients aged 17 or younger within the US Collaborative Network from Jan 2010 to Dec 2022. ICD-10 code P09.6 identified patients who failed their NHS (Group 1). H90.3, H90.4, and H90.5 identified patients diagnosed with SNHL within the Group 1 cohort (Group 2). Z96.21 identified patients within the Group 2 cohort who received cochlear implants (Group 3). The prevalence of failed NHS (Group 1), failed NHS and SNHL diagnosis (Group 2), and cochlear implantation (Group 3) were compared between Caucasian/White (C/W) and Black/African American (B/A) patients.

Results: Group 1 comprised 12,983 children, with 7,401 (57%) males and 5,504 (42.4%) females. Group 2, 1,804 children, with 983 (54.5%) males and 811 (45%) females. Group 3, 153 children, with 79 (51.6%) males and 74 (48.4%) females.

As a formal diagnosis of SNHL was made and children underwent cochlear implantation, the percentage of B/A patients decreased; 2834 (21.8%) patients in Group 1 were B/A compared to 329 (18.2%) in Group 2 and 21 (13.7%) in Group 3. B/A patients were more likely than C/W patients to fail their NHS (OR 1.2; 95% CI 1.2-1.3; p < 0.05), less likely to receive a formal SNHL diagnosis (OR 0.7; 95% CI 0.6-0.8; p < 0.05), and if diagnosed with SNHL, were less likely to undergo cochlear implantation (OR 0.6; 95% CI 0.4-1; p < 0.05).

Conclusions: Despite higher rates of failed newborn hearing screens among Black/African American patients, a significant disparity exists as they are less likely to receive a formal SNHL diagnosis and undergo cochlear implantation compared to White/Caucasian counterparts. This emphasizes the need to address specific barriers to pediatric hearing healthcare in the US by implementing targeted interventions, such as improving access to otologic diagnostic and intervention services.