Examining the Relationship Between Race and Hearing

Loss
hearinghealthfoundation.org/blogs/examining-the-relationship-between-race-and-hearing-loss

HHF Intern February 2, 2016

By Emily Shepard

February is Black History Month, a time dedicated to celebrating achievements and

spreading awareness about issues that affect the African-American community.

With this in mind, we want to publicize the

prevalence of hearing loss among black Americans:
Nearly two million have a hearing
impairment.1 However, research suggests that the
odds of hearing loss are substantially lower for
blacks than those who are white.2 Epidemiologic
studies of large populations have found that the rate
of hearing loss is 40 to 60 percent lower in black
individuals compared with white
individuals.3 While the basis for this connection
remains largely unknown, research has identified a
potential biological influence.

In the study “Association of Skin Color,

Race/Ethnicity, and Hearing Loss Among Adults in
the USA” by Frank R. Lin, M.D., Ph.D., et al., the
authors examine the degree to which skin tone is correlated to hearing loss. The authors
argue that melanocytes, which produce the melanin pigment that determines skin color,
are present in both the skin and cochlea. Increased melanin in the inner ear may help
protect the cochlea against age-related cellular declines and hearing loss in darker-
skinned individuals. Differences in noise exposure or in genetic determinants may also
factor into the connection between race and hearing loss.4

These findings support the idea that race and hearing loss may be connected. For their
study, Lin et al. relied on the Fitzpatrick scale to classify skin types. This scale uses the
skin’s tendency to burn and tan to differentiate skin tone. For example, it says that if one
always burns and never tans, they are likely to have pale white skin. If someone never
burns, they are more likely to have deeply pigmented dark brown to black skin.5 The
authors found that darker skin color as assessed by Fitzpatrick skin type was
independently associated with better hearing thresholds in black and Hispanic
individuals. On the other hand, race and ethnicity were not associated with hearing
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thresholds after stratification by skin color. The authors argue that these results “serve as
preliminary evidence that skin color is independently associated with hearing loss,” and
that skin color “may mediate the strong association between race and hearing loss
observed in previous epidemiological studies.”6

Nonetheless, it is necessary to remember that although black individuals are at less of risk
to experience some form of hearing loss, they are not exempt from it. The role of melanin
as it relates to hearing loss is likely to be perceived similarly to its relationship to skin
cancer. A Washington Post article titled “Many Blacks Are Unaware of a Skin Cancer That
Primarily Affects Dark-Skinned People” explains that those with darker skin tones
produce more melanin overall, and that since melanin helps block damaging ultraviolet
rays, people of color have greater protection against skin cancer than whites.

But the Washington Post article works to dispel the belief that melanoma, the deadliest
form of skin cancer, is a “white person’s disease.” Melanoma is indeed much more
common in whites (1 in 50) than in African Americans (1 in 1,000). However, research
from the American Academy of Dermatology reports that the five-year survival rate for
African Americans with melanoma is 73 percent, compared with 91 percent for
Caucasians. In addition, acral lentiginous melanoma (ALM) is a rare form of skin cancer
that primarily strikes people of color. The disease affects areas of the body that have less
pigment and receive less exposure to the sun, such as the soles of the feet, and are areas
that are more likely to be ignored. ALM can be lethal; reggae musician Bob Marley died
from ALM in 1981 at age 36.7

It is important to recognize that things that seem improbable are not impossible. Even if
your race or ethnicity decreases the chance that you will contract a form of hearing
loss, the best way to ensure healthy hearing is to take protective measures.

HHF strives to spread the word about how you can protect your hearing.

HHF is also committed to finding a cure for the millions of Americans who
currently experience hearing loss or tinnitus.

Donate today to help us make a difference.

1. “How the African American Community Deals with Hearing Impaired Individuals:
A Qualitative Analysis Using Social Learning Theory”- 2012- By Lakeisha O’ Neil

2. Lin, Frank R. et al. “Association of Skin Color, Race/Ethnicity, and Hearing Loss
Among Adults in the USA.” JARO: Journal of the Association for Research in
Otolaryngology 13.1 (2012): 109–117. PMC. Web. 21 Dec. 2015.

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3. Lin FR, Thorpe R, Gordon-Salant S, Ferrucci L. Hearing loss prevalence and risk
factors among older adults in the United States. J Gerontol A Biol Sci Med Sci.
2011; 66:582–590. doi: 10.1093/gerona/glr002.

4. Lin, Frank R. et al. “Association of Skin Color, Race/Ethnicity, and Hearing Loss
Among Adults in the USA.” JARO

5. Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through
VI. Arch Dermatol. 1988;124:869–871. doi:
10.1001/archderm.1988.01670060015008.

6. Lin, Frank R. et al. “Association of Skin Color, Race/Ethnicity, and Hearing Loss
Among Adults in the USA.” JARO

7. https://www.washingtonpost.com/national/health-science/many-blacks-are-
unaware-of-a-skin-cancerthat-primarily-affects-dark-skinned-
people/2014/08/04/14164ada-e68a-11e3-afc6-a1dd9407abcf_story.html

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