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Socioeconomic Status & Permanent Hearing Loss
Anne Greville PhD
Greville Consulting
Auckland, New Zealand
Audiological Society of Australia biennial conferencePerth, WAMay 19, 2006
Thanks to…
• The Deafness Research Foundation of New Zealand for support of the project
• The National Audiology Centre for access to the deafness database & assistance with sourcing addresses
• Simon Jellie of e-Spatial for help in geo-coding the data.
Why look at SES?
• Kubba, MacAndie, Ritchie & MacFarlane Is deafness a disease of poverty? The association between socio-economic deprivation & congenital hearing impairmentInt J Audiol 43:123-5 (2004)
Children in Glasgow born 1985-94
Kubba et al, Glasgow
0
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.8
2
1 2 3 4 5 6 7
Proportion of population
Prevalence/1000 births
• Fortnum, Marshall & SummerfieldEpidemiology of the UK population of hearing-impaired children, including characteristics of those with & without cochlear implants – audiology, aetiology, comorbidity & affluenceInt J Audiol 41:170-9 (2002)
Fortnum et al, UK
0
200
400
600
800
1000
1200
1400
1600
1800
2000
1 2 3 4 5 6 7 8 9 10
Methodology
• Hearing impaired & deaf children notified to the National Audiology Centre’s database
• Limited to children born 1992 – 1999.
• Children with acquired or unilateral hearing loss & those born overseas excluded.
Sample
• 828 children
• 696 children with unambiguous addresses
• 693 children were geocoded into unique meshblocks (approx 100 people)
• Decile ratings available for meshblocks
Socioeconomic Measure• NZ Dep2001 Index of Deprivation
Salmond & Crampton (2002)• Based on:
– incomeemploymentcommunicationtransportsupportqualificationsliving spaceowned home
• SES Measure: deciles 1-10 (10 most deprived)
• Fairly even distribution into tenths of total population
• For children < 15 years, 13% are in decile 10, 8% decile 5
• Over 20% of Maori population in decile 10
• 40% of Pacific Island population in decile 10
Birth year
0
20
40
60
80
100
120
140
1992 1993 1994 1995 1996 1997 1998
Birth year
Number of deaf children per decile
y = 2.5189x2 - 15.63x + 58.283
R2 = 0.9285
0
20
40
60
80
100
120
140
160
180
200
1 2 3 4 5 6 7 8 9 10
Decile and age (at 2001)
0
20
40
60
80
100
120
140
160
180
200
1 2 3 4 5 6 7 8 9 10
Decile
Children born 1992-6
Children born 1997-9
Deafness prevalence & deprivation
0
0.5
1
1.5
2
2.5
3
3.5
4
1 2 3 4 5 6 7 8 9 10
Deprivation Index
Pre
vale
nce
/100
0
Children born 1997-9
Children born 1992-6
Overall
Ethnicity
0
20
40
60
80
100
120
140
160
180
1 2 3 4 5 6 7 8 9 10
Unknown
Pacific Id
Other
Maori
European
Asian
H/Loss moderate or greater
0
10
20
30
40
50
60
70
80
90
1 2 3 4 5 6 7 8 9 10
Unknown
Pacific Id
Other
Maori
European
Asian
y = 28.667x0.0788
R2 = 0.1584
y = 2.3084e0.3649x
R2 = 0.9744
0
20
40
60
80
100
120
1 2 3 4 5 6 7 8 9 10
Maori
non-Maori
Power (non-Maori)
Expon. (Maori)
H/Loss moderate or greater
y = 0.6783x1.5526
R2 = 0.8115
y = 15.19x0.1611
R2 = 0.3686
0
5
10
15
20
25
30
35
40
45
50
1 2 3 4 5 6 7 8 9 10
Maori
non-Maori
Power (Maori)
Power (non-Maori)
Maori deaf children cf Maori population
0%
5%
10%
15%
20%
25%
30%
35%
40%
1 2 3 4 5 6 7 8 9 10
Maori deaf children
Total Maori population
Cause of deafness
0
20
40
60
80
100
120
140
160
180
200
1 2 3 4 5 6 7 8 9 10
Unknown
Other
Multiple
Low birthweight
Jaundice
Family history
Facial malformation
Congenital infection
Asphyxia
Cause of deafness among Maori children
0
20
40
60
80
100
120
1 2 3 4 5 6 7 8 9 10
Unknown
Other
Multiple
Low birthweight
Jaundice
Family history
Facial malformation
Congenital infection
Asphyxia
Household income levels
Ethnic group Mean household income
($,000)
Asian 51.3
European 50.6
Pacific Island 44.0
Other 41.4
Maori 39.1
Overall 44.9
Conclusions
• In New Zealand, there is no apparent effect of SES on congenital hearing loss for ethnic groups other than Maori
• Among the Maori children, unknown cause & family history are the major causal factors
… and…
• Does a family history of deafness in Maori mean that the family is more likely to live in a low SES area?
• Maori deaf/hearing impaired children are more likely to live in a low income household than are deaf children from other ethnic groups.
Thank you