Ear and hearing health of Aboriginal and Torres Strait Islander people 2025

Hearing aids and cochlear implants help many people with hearing loss to hear better. While they work in different ways, these and other hearing devices can enable people to understand speech, even in noisy environments. Using a hearing device can improve people’s mood and physical health and increase social participation. When children with hearing loss are fitted with hearing devices at a young age, they are more likely to have better speech and language development (Ching et al. 2018).

Hearing Australia clients with hearing aids or cochlear implants

Overview

As at 31 December 2024, there were 207,546 Hearing Australia clients with a hearing device (hearing aid or cochlear implant). There were 7,947 Hearing Australia First Nations clients with hearing devices (4% of total), and most of these had hearing aids (99%) (Data Table 4.1.1a, Data Table 4.1.1f).

Age

Of the 7,947 First Nations Hearing Australia clients with hearing devices, 73% (5,803) were aged 50 and over.

Similarly, reflecting the higher prevalence of hearing loss in the older population, a much higher rate of First Nations people aged 50 and over were Hearing Australia clients with hearing devices (29.8 per 1,000 population), compared with younger First Nations people (2.1 per 1,000 population aged 26-49, and 2.6 per 1,000 population aged 15–25 and 2.8 per 1,000 population aged 0–14) (Figure REHABILITATION 1).

Adults over 50 years are likely more affected by sensorineural hearing loss and an amplification device such as a hearing aid is an appropriate solution. Children are more likely to experience conductive hearing loss linked to middle ear disease and a device such as a hearing aid is unlikely to be the first option however may be considered if surgery or other treatments have not been successful.

Children

For all age groups except those aged 0–2, the rate of First Nations people who were Hearing Australia clients with a hearing device was higher than that of non-Indigenous Australians

The rate of First Nations children who were Hearing Australia clients with a hearing device was higher among those aged 7–9 (265 children, 4.1 per 1,000 population) and 10–14 (393, 3.6 per 1,000 population) than children in lower age groups between 0–14 (Data Table 4.1.1a).

First Nations children aged 0–14 were over 1.5 times as likely as non-Indigenous children to be Hearing Australia clients with a hearing device, with a rate of 2.8 per 1,000 population compared to 1.7 per 1,000 population for non-Indigenous children (Figure REHABILITATION 2).

Sex

There were 3,658 First Nations Hearing Australia male clients (6.9 per 1,000 population) and 4,278 female clients (8.2 per 1,000 population). The largest difference between males and females in the rates of First Nations Hearing Australia clients was observed in the 26-49 age group, where the rate for females was nearly double that of males (2.8 and 1.5 per 1,000 population respectively). (Figure REHABILITATION 3). This may reflect differences in health-seeking behaviour, access to services, or underlying patterns in ear health conditions.

Remoteness

The rate of First Nations Hearing Australia clients increased with remoteness, from 5.5 per 1,000 population in Major cities, to 8.1 per 1,000 in Inner and outer regional areas, and around 8.7 per 1,000 in Remote and very remote areas.

In particular, the rate of First Nations Hearing Australia clients was markedly higher in Remote and very remote areas than in non-remote areas among the younger age groups. For those aged 0–14 and those aged 15–25, the rates in Remote and very remote areas were nearly 3 times those in Major cities or Inner and outer regional areas (Figure REHABILITATION 4).

Among the 0–14 and 15–25 age groups, higher rates of chronic middle ear disease in remote and very remote areas may partly explain the higher rates of First Nations clients receiving hearing aids and cochlear implants in those areas.

State and territory

Across states and territories, First Nations Hearing Australia clients with a hearing aid or cochlear implant ranged from 6.4 per 1,000 population (2,311) in New South Wales to 13.3 per 1,000 population (1,044) in the Northern Territory (Figure REHABILITATION 5).

The rate of First Nations Hearing Australia clients with a hearing aid or cochlear implant was highest in the 50 years and over age group for all states and territories, ranging from 22.3 per 1,000 (508) in Western Australia to 42.8 per 1,000 (627) in the Northern Territory.

Among those aged 0–14, the rate of First Nations Hearing Australia clients with a hearing aid or cochlear implant ranged from 1.1 per 1,000 population (12) in Tasmania to 8.1 per 1,000 population (168) in the Northern Territory.

Type of device

As at 31 December 2024, 7,911 First Nations Hearing Australia clients with a hearing device (99.5%) had a hearing aid and about 78 (1%) had a cochlear implant. Some clients had both devices.

Among First Nations Hearing Australia clients with a hearing device, larger proportions of children 0–14 had a cochlear implant compared with those aged 15 and over, although across all age groups the majority had hearing aids. Of First Nations Hearing Australia clients with a hearing device:  

• 99.1% (909) of children 0–14 had a hearing aid, 2.7% (25) had a cochlear implant
• 99.7% (574) of those aged 15–25 had a hearing aid, 1.6% (9) had a cochlear implant
• 98.9% (644) of those aged 26–49 had a hearing aid, 1.8% (12) had a cochlear implant
• 99.7% of those aged 50 and over (5,784) had a hearing aid, 0.6% (32) had a cochlear implant (Data table 4.1.1f).

Cochlear implants are primarily suitable for people with severe or profound hearing loss. Given that only a relatively small proportion of people have this level of hearing loss, the proportion of people receiving cochlear implants is also relatively small.

Level of hearing loss

The level of hearing loss is based on the level of hearing loss in the better ear, using a classification of severity of hearing loss for children.

As at 31 December 2024, at their latest hearing test, for First Nations Hearing Australia clients with hearing devices:

• 3,168 (39.9%) had normal hearing or mild hearing loss (could hear sounds in the range 0–40dB)
• 2,525 (31.8%) had moderate hearing loss (41–60dB)
• 2,228 (28.0%) had severe or profound hearing loss (61–90dB).

Across age groups, the proportion with moderate to severe/profound hearing loss was greatest among First Nations clients aged 26–49 (68%) (Figure REHABILITATION 6).

As at 31 December 2024, at their latest hearing test, for First Nations Hearing Australia clients with hearing devices aged 0–14:

• 538 (58.7%) had normal hearing or mild hearing loss
• 252 (27.4%) had moderate hearing impairment
• 106 (11.6%) had severe or profound hearing impairment

These results show that most of those who wear hearing devices have normal hearing or mild hearing loss, while a smaller proportion have moderate hearing loss and a smaller proportion again have severe or profound hearing loss. (Figure REHABILITATION 7). That is, very broadly, these results reflect the prevalence in the population of hearing loss at these different levels of severity.

Age when hearing device was first fitted

For Hearing Australia clients aged 0–25 with a hearing aid or a cochlear implant, information on the age when their hearing device was first fitted is available for the period 2008 to 2024.

Overview

There were 6,071 First Nations clients of Hearing Australia aged 0–25 who had been fitted with a hearing aid or cochlear implant between 2008 and 2024. Of these, most (5,375 or 88.5%) were aged 0–14.

Age

In 2024, 436 First Nations people aged 0–25 were fitted with a hearing aid or cochlear implant for the first time. Of these:

• 40.6% (177) were aged 0–4 when fitted with their hearing device
• 31.4% (137) were aged 5–9 when fitted with their hearing device
• 13.1% (57) were aged 10–14 when fitted with their hearing device
• 14.9% (65) were aged 15–25 when fitted with their hearing device.

The peak ages of first hearing device fitting for First Nations Hearing Australia clients aged 0–25 in 2024 were from 2–6 years, with the proportion fitted at each of these ages ranging from 8.0% to 11.0%. In total, about 46.8% of First Nations people aged 0–25 first fitted with a hearing device in 2024 were aged 2–6.

For non-Indigenous Hearing Australia clients aged 0–25 in 2024, the peak age of first hearing device fitting was under one year of age (18.8% or 565 people), with a smaller, secondary peak at age 5 and 6 (both 5.4% or 162) (Figure REHABILITATION 8).

The differences between First Nations children and non-Indigenous children in the early ages reflect the different causes of hearing loss, rather than access to services. Non-Indigenous children are more often referred for sensorineural hearing loss, which is detected by newborn hearing screening, and are often fitted in the first year or two of life. In contrast, First Nations children are often fitted due to hearing loss from chronic middle ear infection, frequently occurring between the ages of 2 and 6 years. 

Over time

Between 2008 and 2024, there was a trend towards First Nations Hearing Australia clients being fitted with their hearing device at a younger age. The proportion first fitted with their hearing device aged 0–4 increased from 13.3% (29) in 2008 to 40.6% (177) in 2024 (Figure REHABILITATION 9).

The peak age at which the hearing device was first fitted fell from 6 years (12.4%) in 2008 to 5 years of age (11.0%) in 2024 (Figure REHABILITATION 10).