Ethnic, Gender, and Other Demographic Disparities in Cochleovestibular Symptoms in the United States

Objective: To analyze demographic disparities in the prevalence of cochleovestibular symptoms including hearing loss, tinnitus, and dizziness. Methods: The National Health and Nutrition Examination Survey (NHANES) database was queried for the prevalence of cochleovestibular symptoms among random samples of US survey participants between 1999 and 2018. Welch t test, mean difference, and χ 2 analyses were performed to compare demographic differences between healthy and symptomatic patients. Multivariate logistic regression was also performed for each symptom. Results: Participants who reported having hearing loss (OR=3.93, P <0.001) or tinnitus (OR=2.04, P <0.001) were significantly older than healthy individuals. However, older age was not a risk factor for having dizziness ( P =0.281). Similarly, BMI was significantly higher among participants with hearing loss (OR=1.33, P <0.001) and tinnitus (OR=1.27, P <0.001), although this was not true of dizziness ( P =0.992). Men had a higher likelihood of developing hearing loss (OR=1.75, P <0.001), whereas women had a higher likelihood of developing dizziness (OR=1.73, P <0.001). No significant gender difference was evident for tinnitus ( P =0.304). Black, Hispanic, and multi-racial participants were less likely than White subjects to develop hearing loss or tinnitus (all P <0.001). In contrast, the odds of developing dizziness were greater among all ethnicities other than White; however, this greater odd was only statistically significant in Hispanics ( P =0.033). Conclusions: Cochleovestibular symptoms’ prevalence varies across US demographics and racial/ethnical groups. Knowledge of these disparities, whether the result of biological or societal effects, can help identify at-risk populations. These insights can further inform health care policy decisions and improve care delivery for patients affected by these disorders.