Borderland Hearing Health: Insights From Community-Based Screenings.

Abstract

IMPORTANCE: Underserved populations, especially Hispanics along the U.S.-Mexico border, are systematically excluded from early hearing loss detection efforts. Without targeted, culturally informed approaches, existing health disparities will only be exacerbated. This study addresses a critical gap in equitable access to hearing health care for Hispanic individuals in the United States. OBJECTIVE: The aim of this study was to examine the outcomes of community-based hearing screenings embedded within a mobile health outreach program in El Paso, Texas, and identify demographic predictors of screening failure. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed data from 305 participants (274 Hispanics) who underwent hearing screenings at six mobile health events. Screenings included otoscopy, pure-tone audiometry, and a brief case history. Logistic regression was used to evaluate the association between demographic variables and hearing screening outcomes. MAIN OUTCOMES AND MEASURES: The primary outcome was hearing screening failure. Demographic predictors included age, gender, ethnicity, primary language, insurance status, and zip code-based income category. RESULTS: Among the 305 participants, 57% failed the hearing screening. A majority (64.4%) reported suspected hearing loss. Older age was significantly associated with screening failure. Compared with privately insured individuals, those with no insurance or public insurance had significantly higher odds of failure. Males were also more likely to fail than females. Primary language and income-based zip code were not significantly associated with screening outcomes. CONCLUSIONS AND RELEVANCE: Embedding hearing screenings within community health outreach initiatives can improve access among underserved populations, though uptake remains low. Age, insurance status, and gender were significant predictors of hearing screening failure among participants, highlighting individual differences that can inform more targeted outreach and intervention strategies in Hispanic communities. To reduce disparities and advance equity in hearing health care access, mobile outreach programs should integrate culturally responsive care, bilingual providers, and robust follow-up systems. These findings support the development of inclusive, community-based models to reach populations historically underserved by traditional health care systems.