Hearing aids and cochlear implants
-
There were around 8,200 Hearing Australia First Nation clients with a hearing device at 30 June 2023.
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).
About the data
This section presents information about First Nations people with a hearing aid or cochlear implant who received support services from Hearing Australia through the Hearing Services Program. Information presented includes demographic characteristics, the severity and type of hearing loss, and age when the hearing device was first fitted.
The information comes from Hearing Australia, which provides specialist hearing rehabilitation services and hearing devices to eligible people under the community service obligation component of the Hearing Services Program (Hearing Australia 2021).
Differences in rates between First Nations and non-Indigenous clients of Hearing Australia, particularly for those aged 26 and over, may influenced by different Hearing Services Program eligibility criteria for the two groups.
The data on hearing loss presented in this section are based on the ear with better hearing among Hearing Australia clients fitted with a hearing device. These data are not directly comparable with those in the Measured hearing loss and severity section, which present information on the severity of any hearing loss among all First Nations people, excluding those with a cochlear implant.
The classification of severity of hearing loss in this section also differs slightly from that used in the Measured hearing loss and severity section.
Remoteness classifications for this section have been derived from the Modified Monash Model remoteness classifications.
Hearing Australia clients with hearing aids or cochlear implants
Overview
As at 30 June 2023, there were around 180,000 Hearing Australia clients with a hearing device (hearing aid or cochlear implant). Around 8,200 Hearing Australia clients with hearing devices were First Nations people (4.5%), and most of these had hearing aids (98%) (Data Table 4.1.1a, Data Table 4.1.1f).
Age
Of the 8,200 First Nations Hearing Australia clients with hearing devices, 7 in 10 (70% or 5,800) 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 (31 per 1,000 population), compared with younger First Nations people (just over 2 per 1,000 population aged 15–25 and 26–49, and 4 per 1,000 population aged 0–14).
For all age groups except those aged 15–25, the rate of First Nations people who were Hearing Australia clients with a hearing device was higher than that of non-Indigenous Australians (Figure REHABILITATION 1).
Figure REHABILITATION 1: Hearing Australia clients with a hearing aid or cochlear implant, by Indigenous status and age, 2022–23
Column graph shows rate of Hearing Australia clients with a hearing device for First Nations people 50 and over about double that of non-Indigenous.
| Age group | First Nations | Non-Indigenous |
|---|---|---|
| 0–14 | 4 | 3 |
| 15–25 | 2.1 | 2.5 |
| 26–49 | 2.2 | 0.7 |
| 50 and over | 30.9 | 15.9 |
- Eligibility criteria differ for Indigenous and non-Indigenous Australians.
- Rates are calculated using ABS backcast population estimates and projections based on the 2021 Census.
Source: AIHW analysis of Hearing Australia data, unpublished; and ABS population estimates and projections for rate calculations.
Children
The rate of First Nations children who were Hearing Australia clients with a hearing device was higher among those aged 5–6 (230 children, 5.4 per 1,000 population) and 7–9 (around 335, 5.1 per 1,000 population) than children in other age groups between 0–14 (Data Table 4.1.1a).
First Nations children aged 0–14 were 1.3 times as likely as non-Indigenous children to be Hearing Australia clients with a hearing device, with a rate of 4.0 per 1,000 population compared to 3.0 per 1,000 for non-Indigenous children (Figure REHABILITATION 2).
Figure REHABILITATION 2: Hearing Australia clients aged 0–14 with a hearing aid or cochlear implant, by Indigenous status and age, 2022–23
Column graph shows rate of Hearing Australia clients with a hearing device for First Nations higher than non-Indigenous children, mostly for 3–9 years.
| Age | First Nations | Non-Indigenous |
|---|---|---|
| 0–2 | 2.17 | 2 |
| 3–4 | 3.69 | 2.6 |
| 5–6 | 5.43 | 3 |
| 7–9 | 5.14 | 3.4 |
| 10–14 | 4.16 | 3.4 |
- Eligibility criteria differ for Indigenous and non-Indigenous Australians.
- Rates are calculated using ABS backcast population estimates and projections based on the 2021 Census.
Source: AIHW analysis of Hearing Australia data, unpublished; and ABS population estimates and projections for rate calculations.
Sex
About 3,700 First Nations Hearing Australia clients were male (7.2 per 1,000 population) and 4,500 were female (8.8 per 1,000 population). Similar rates of First Nations Hearing Australia clients were boys aged 0–14 (4.1 per 1,000 population) and girls aged 0–14 (4.0 per 1,000 population) (Figure REHABILITATION 3).
Figure REHABILITATION 3: First Nations Hearing Australia clients with a hearing aid or cochlear implant, by sex and age, 2022–23
Column graph shows rate of First Nations Hearing Australia clients with a hearing device similar by sex for 0–14 years, lower for males at other ages.
| Age group | Male | Female |
|---|---|---|
| 0–14 | 4.1 | 4 |
| 15–25 | 1.8 | 2.4 |
| 26–49 | 1.5 | 2.9 |
| 50 and over | 29.4 | 32.2 |
- Rates are calculated using ABS backcast population estimates and projections based on the 2021 Census.
Source: AIHW analysis of Hearing Australia data, unpublished; and ABS population estimates and projections for rate calculations.
Remoteness
The rate of First Nations Hearing Australia clients increased with remoteness, from 5.8 per 1,000 population in Major cities, to 7.8 per 1,000 in Inner and outer regional areas, and around 15 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 those aged 0–14 and those aged 25–49, where the rates in remote areas were more than three times those in Major cities or Inner and outer regional areas (Figure REHABILITATION 4).
Figure REHABILITATION 4: First Nations Hearing Australia clients with a hearing aid or cochlear implant, by remoteness and age, 2022–23
Column graph shows rate of First Nations Hearing Australia clients with a hearing device higher in remote areas notably in 0–14 and 26–49 ages.
| Age group (years) | Major cities | Inner/outer regional | Remote/very remote |
|---|---|---|---|
| 0–14 | 3.2 | 2.8 | 11 |
| 15–25 | 1.7 | 2 | 3.6 |
| 26–49 | 1.3 | 1.9 | 5.3 |
| 50 and over | 24.5 | 30.4 | 47 |
- Rates are calculated using ABS backcast population estimates and projections based on the 2021 Census.
- Remoteness classifications have been derived from the Modified Monash Model remoteness categories.
Source: AIHW analysis of Hearing Australia data, unpublished; and ABS population estimates and projections for rate calculations.
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 in New South Wales to 16 per 1,000 population 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 26 per 1,000 to 53 per 1,000.
Among those aged 0–14, the rate of First Nations Hearing Australia clients with a hearing aid or cochlear implant ranged from 1.5 per 1,000 population in Tasmania to 11.4 per 1,000 population in the Northern Territory.
Figure REHABILITATION 5: First Nations Hearing Australia clients with a hearing aid or cochlear implant, by state/territory and age, 2022–23
Column graph shows rate of First Nations Hearing Australia clients with a hearing device highest in Northern Territory, lowest in New South Wales.
| State/territory | 0–14 | 15–25 | 26–49 | 50 and over |
|---|---|---|---|---|
| NSW/ACT | 2.4 | 1.7 | 1.5 | 26 |
| Vic | 2.8 | 2 | 1.8 | 29.1 |
| Qld | 4.4 | 2.2 | 2 | 32.3 |
| WA | 6.1 | 2.6 | 1.5 | 27.7 |
| SA | 3.6 | 2.6 | 3.7 | 30.5 |
| Tas | 1.5 | 0.9 | 1.2 | 38 |
| NT | 11.4 | 3.4 | 6.5 | 52.8 |
- Percentages are the proportion in each state/territory within each age group.
- Rates are calculated using ABS backcast population estimates and projections based on the 2021 Census.
Source: AIHW analysis of Hearing Australia data, unpublished; and ABS population estimates and projections for rate calculations.
Type of device
As at 30 June 2023, about 8,000 First Nations Hearing Australia clients with a hearing device (98%) had a hearing aid and about 145 (1.8%) had a cochlear implant.
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:
- about 96% of children 0–14 (1,270) had a hearing aid, 4.4% (58) had a cochlear implant
- 94% of those aged 15–25 (415) had a hearing aid, 6.1% (27) had a cochlear implant
- 97% of those aged 26–49 (640) had a hearing aid, 2.6% (17) had a cochlear implant
- 99% of those aged 50 and over (5,700) had a hearing aid, 1.8% (45) had a cochlear implant (Data table 4.1.1f).
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 30 June 2023, at their latest hearing test, for First Nations Hearing Australia clients with hearing devices:
- 4,600 (56%) had normal hearing or mild hearing loss (could hear sounds in the range 0–40dB)
- 2,300 (28%) had moderate hearing loss (41–60dB)
- 1,300 (16%) 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 (59%) (Figure REHABILITATION 6).
Figure REHABILITATION 6: First Nations Hearing Australia clients with a hearing aid or cochlear implant, by severity of hearing loss and age, 2022–23
Bar chart shows for First Nations Hearing Australia clients with a hearing device, highest proportion with more severe hearing loss highest in 26–49.
| Age | Normal/mild | Moderate | Severe/profound | Unknown |
|---|---|---|---|---|
| 0–14 | 74.9 | 16.3 | 7.5 | 1.2 |
| 15–25 | 64.9 | 21.5 | 13.6 | 0 |
| 26–49 | 40.8 | 29.3 | 29.7 | 0.2 |
| 50 and over | 52.5 | 31.3 | 16.1 | 0 |
- Hearing impairment level is the measured hearing impairment in the better ear at the most recent assessment.
- Percentages are the proportion among Indigenous Hearing Australia clients within each age group.
Source: AIHW analysis of Hearing Australia data, unpublished; and ABS population estimates and projections for rate calculations.
As at 30 June 2023, at their latest hearing test, for First Nations Hearing Australia clients with hearing devices aged 0–14:
- about 1,000 (75%) had normal hearing or mild hearing loss
- 215 (16%) had moderate hearing impairment
- 100 (7.5%) had severe or profound hearing impairment (Figure REHABILITATION 7).
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. That is, very broadly, these results reflect the prevalence in the population of hearing loss at these different levels of severity.
Further analysis is required to understand what proportions of people with mild, moderate or severe hearing loss have a hearing device. For example, it would be expected that the proportion of those with a hearing device would be greatest among those with more severe levels of hearing loss.
Figure REHABILITATION 7: First Nations Hearing Australia clients aged 0–14 with a hearing aid or cochlear implant, by severity of hearing loss and single year of age, 2022–23
Line chart shows variations by single year age in percentage of First Nations Hearing Australia clients with a hearing device by hearing loss severity.
| Age | Normal/mild | Moderate | Severe/profound |
|---|---|---|---|
| <1 | 57.7 | 23.1 | 19.2 |
| 1 | 49.1 | 26.4 | 13.2 |
| 2 | 60.9 | 24.6 | 7.2 |
| 3 | 62.5 | 21.9 | 12.5 |
| 4 | 71.7 | 19.6 | 5.4 |
| 5 | 82.5 | 15.5 | 2.1 |
| 6 | 82.7 | 9 | 8.3 |
| 7 | 72.8 | 17.5 | 9.6 |
| 8 | 84.2 | 13.2 | 2.6 |
| 9 | 80.2 | 13.2 | 6.6 |
| 10 | 81.1 | 10.4 | 8.5 |
| 11 | 77.5 | 13.5 | 9 |
| 12 | 66.7 | 21.8 | 11.5 |
| 13 | 78.5 | 16.5 | 5.1 |
| 14 | 76.7 | 18.6 | 4.7 |
- Hearing impairment level is the measured hearing impairment in the better ear at the most recent assessment at or before 31 December 2019.
- Percentages are the proportion among Indigenous Hearing Australia clients within each age group.
* Eligibility criteria differ for First Nations and non-Indigenous Hearing Australia clients aged 26 and over, affecting comparisons by Indigenous status.
Source: AIHW analysis of Hearing Australia data, unpublished.
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 2022.
Overview
There were about 5,800 First Nations clients of Hearing Australia aged 0–25 who had been fitted with a hearing aid or cochlear implant between 2008 and 2022. Of these, most (around 4,800 or 83%) were aged 0–14.
Age
In 2022, around 470 First Nations people aged 0–25 were fitted with a hearing aid or cochlear implant for the first time. Of these:
- 36% (170) were aged 0–4 when fitted with their hearing device
- 33% (around 155) were aged 5–9 when fitted with their hearing device
- 16% (75) were aged 10–14 when fitted with their hearing device
- 15% (70) were aged 15–25 when fitted with their hearing device.
About 9% of First Nations children and young adults first fitted with a hearing device in 2022 were under the age of one.
The peak ages of first hearing device fitting for First Nations Hearing Australia clients aged 0–25 in 2022 were from 3–6 years, with the proportion fitted at each of these ages ranging from 8% to 10%. In total, 35% of First Nations people aged 0–25 first fitted with a hearing device in 2022 were aged 3–6.
For non-Indigenous Hearing Australia clients aged 0–25 in 2022, the peak age of first hearing device fitting was under one year of age (around 19% or 550 people), with a smaller, secondary peak at age 5 (6% or about 185) (Figure REHABILITATION 8).
Figure REHABILITATION 8: Hearing Australia clients, by age first fitted with a hearing aid or cochlear implant and Indigenous status, 2022
Line chart shows higher percentage of non-Indigenous Hearing Australia clients with hearing device were fitted aged 0–1 than First Nations clients.
| Age | First Nations | Non-Indigenous |
|---|---|---|
| <1 | 9 | 19 |
| 1 | 4 | 5 |
| 2 | 6 | 4 |
| 3 | 8 | 4 |
| 4 | 8 | 5 |
| 5 | 10 | 6 |
| 6 | 8 | 5 |
| 7 | 6 | 4 |
| 8 | 5 | 3 |
| 9 | 3 | 3 |
| 10 | 3 | 3 |
| 11 | 4 | 3 |
| 12 | 4 | 3 |
| 13 | 2 | 2 |
| 14 | 3 | 3 |
| 15 | 1 | 3 |
| 16 | 2 | 2 |
| 17 | 1 | 3 |
| 18 | 1 | 2 |
| 19 | 2 | 2 |
| 20 | 1 | 2 |
| 21 | 0 | 2 |
| 22 | 1 | 2 |
| 23 | 0 | 2 |
| 24 | 2 | 3 |
| 25 | 2 | 4 |
- Percentages are the proportion in each age group among First Nations and non-Indigenous Australian clients, respectively.
Source: AIHW analysis of Hearing Australia data, unpublished.
Over time
Between 2008 and 2022, 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 10% in 2008 to 36% in 2022 (Figure REHABILITATION 9).
Figure REHABILITATION 9: First Nations Hearing Australia clients, by age first fitted with a hearing aid or cochlear implant, 2008 to 2022
Line chart shows trend for First Nations Hearing Australia clients with hearing device being fitted with the device at a younger age.
| Year | 0–4 | 5–9 | 10–14 | 15–25 |
|---|---|---|---|---|
| 2008 | 9.8 | 43 | 23.9 | 23.3 |
| 2009 | 14.3 | 40.4 | 22.9 | 22.3 |
| 2010 | 13.4 | 44.4 | 23.9 | 18.3 |
| 2011 | 17.5 | 37.6 | 28.4 | 16.6 |
| 2012 | 16.2 | 42.6 | 19.9 | 21.3 |
| 2013 | 21.7 | 38.8 | 22.1 | 17.5 |
| 2014 | 23.7 | 40.5 | 23.7 | 12.1 |
| 2015 | 26.9 | 42.6 | 15.1 | 15.4 |
| 2016 | 20.4 | 42.3 | 19 | 18.3 |
| 2017 | 23.5 | 37.5 | 20.9 | 18.1 |
| 2018 | 23.2 | 39.9 | 19.8 | 17.1 |
| 2019 | 25.1 | 39.9 | 20.9 | 14.2 |
| 2020 | 21.5 | 42.4 | 20.8 | 15.3 |
| 2021 | 36.6 | 28.3 | 19.5 | 15.6 |
| 2022 | 36.3 | 32.7 | 16 | 15 |
- Percentages are the proportion in each age group within each year.
Source: AIHW analysis of Hearing Australia data, unpublished.
The peak age at which the hearing device was first fitted fell from 7–9 years to 4–6 years of age between 2008 and 2022 (Figure REHABILITATION 10).
Figure REHABILITATION 10: First Nations Hearing Australia clients, by age first fitted with a hearing aid or cochlear implant, 2008 and 2022
Line chart shows peak age of first device fitting for First Nations Hearing Australia clients was younger in 2022 at 5 years, was 8 years in 2008.
| Age | 2008 | 2022 |
|---|---|---|
| <1 | 0 | 9.4 |
| 1 | 0 | 4.1 |
| 2 | 2.1 | 6.2 |
| 3 | 1.9 | 8.3 |
| 4 | 3.7 | 8.3 |
| 5 | 6.6 | 10.3 |
| 6 | 7.4 | 7.9 |
| 7 | 9.5 | 6.2 |
| 8 | 9.8 | 4.9 |
| 9 | 9.5 | 3.4 |
| 10 | 4.8 | 3.4 |
| 11 | 5.6 | 3.6 |
| 12 | 6.6 | 3.6 |
| 13 | 3.7 | 2.4 |
| 14 | 3.2 | 3 |
| 15 | 3.2 | 1.5 |
| 16 | 2.9 | 1.7 |
| 17 | 4 | 1.3 |
| 18 | 1.6 | 1.3 |
| 19 | 2.1 | 1.7 |
| 20 | 4.2 | 0 |
| 21 | 0 | 0 |
| 22 | 0 | 0 |
| 23 | 0 | 0 |
| 24 | 0 | 2.4 |
| 25 | 0 | 1.9 |
- Percentages are the proportion in each age group within each year.
Source: AIHW analysis of Hearing Australia data, unpublished.
Type of hearing loss
Among Hearing Australia clients aged 0–14 who were first fitted with a hearing device between 2008 and 2022, larger proportions of First Nations children had conductive hearing loss, compared with non-Indigenous children. Conductive hearing loss means that sound cannot get through the outer and middle ear (ASHA 2024). Middle ear infections are a common cause of conductive hearing loss.
About 50% of First Nations clients aged 2–14 when they were first fitted with a hearing device between 2008 and 2022 had conductive hearing loss, compared with about 24% of non-Indigenous clients.
Among First Nations children, the proportion fitted with a hearing device for conductive hearing loss peaked at ages 4–8 (56% were fitted). Among non-Indigenous children, the peak of fitting for conductive hearing loss was lower and flatter, with around 40% of non-Indigenous children fitted aged 4–8 (Figure REHABILITATION 11).
Figure REHABILITATION 11: Hearing Australia clients with conductive hearing loss, first fitted with a hearing aid or cochlear implant between 2008 and 2022, by age first fitted and Indigenous status
Column chart shows higher percentage of First Nations Hearing Australia clients 0–14 with hearing device had conductive hearing loss than non-Indigenous.
| Age | First Nations | Non-Indigenous |
|---|---|---|
| <1 | 14.4 | 14.2 |
| 1 | 37 | 26.7 |
| 2 | 45.2 | 25.6 |
| 3 | 46.2 | 26.2 |
| 4 | 56.7 | 26.2 |
| 5 | 53.7 | 29.4 |
| 6 | 53.6 | 29.9 |
| 7 | 53 | 28.6 |
| 8 | 58.6 | 28.7 |
| 9 | 48.6 | 26.1 |
| 10 | 50.7 | 24.7 |
| 11 | 41.7 | 24.5 |
| 12 | 39.9 | 25 |
| 13 | 41 | 22.8 |
| 14 | 35.1 | 21.6 |
- Percentages are the proportion in each age group among First Nations and non-Indigenous Australian clients, respectively.
Source: AIHW analysis of Hearing Australia data, unpublished.
AIHW (Australian Institute of Health and Welfare) (2022) Ear and hearing health of Aboriginal and Torres Strait Islander people 2021, AIHW, Australian Government, accessed 1 October 2024.
ASHA (American Speech-Language-Hearing Association) (2024) Conductive Hearing Loss, ASHA, accessed 1 October 2024.
Department of Health and Aged Care (2024), About the Hearing Services Program, Australian Government, DoHAC, accessed 1 October 2024.
Ching TY, Dillon H, Leigh G and Cupples L (2018) ‘Learning from the longitudinal outcomes of children with hearing impairment (LOCHI) study: summary of 5-year findings and implications’, International Journal of Audiology, 57:S105–S111.
Hearing Australia (2021) ‘Improving ear health and hearing outcomes for Aboriginal and Torres Strait Islander children- An Action Plan for Hearing Australia 2022 to 2025’, Hearing Australia, accessed 17 September 2024.