The World Health Organization (WHO) estimates that by 2050, nearly 2.5 billion people worldwide may experience hearing loss, with over 700 million needing rehabilitation. Around 63 million people, or 6.3% of India’s population live with significant auditory impairment. Despite the scale of the problem however, hearing loss often remains an invisible challenge.
“Hearing impairment doesn’t manifest physically, making it harder to identify and address,” says Mohan Kameswaran, founder-director of the Madras ENT Research Foundation. According to Dr. Kameswaran, while the global average indicates that one in 1,000 newborns is born with significant hearing loss, the number is twice as high in India. Alarmingly, a significant percentage of those affected are children aged 0 to 14 years.
Identifying the problem in children
A survey conducted by the Madras ENT Research Foundation among schoolchildren in Chennai a few years ago, revealed that 5% of students had undiagnosed hearing loss, says Dr. Kameswaran. “These children are often thought to be slow learners or as having learning disabilities,” he explains. “In reality, their hearing impairment affects language skills and cognitive development.”
In Tamil Nadu especially, the burden is even higher than the Indian average, he says, with six in every 1,000 newborns affected. “Congenital infections like rubella, neonatal complications such as low birth weight, and birth injuries contribute to this.”
As children grow, the issue becomes more complex. N. Ahilasamy, Chief ENT surgeon and HOD at Prashanth Multispecialty Hospital, Chennai, stresses the need for early screening. “Treatable conditions like fluid buildup in the ears due to recurring colds or chronic infections often go unchecked,” he says. “Without timely treatment, these seemingly small issues can evolve into long-term hearing problems.”
For young adults, hearing loss stems less from birth-related causes and also from lifestyle choices. Dr. Kameswaran and Dr. Ahilasamy warn of the growing risk posed by “electronic pollution”, the overuse of headphones, Bluetooth devices, and mobile phones. “There’s a simple rule, the 60-60 rule,” says Dr. Kameswaran. “Listen at 60% volume for no more than 60 minutes at a time. Most people don’t follow this, though.”
The consequences are not always immediate, which often leads to delays in seeking help. “Hearing damage accumulates slowly,” says Dr. Ahilasamy. “By the time people seek help, the damage is permanent.” Recreational noise exposure from loud concerts, home theatre systems, and high-volume phone calls further pushes people beyond safe noise levels. “You might step out of a loud event with ringing ears: that’s a temporary threshold shift,” explains Dr. Kameswaran. “But sometimes it becomes permanent.”
Government interventions
The National Programme for Prevention and Control of Deafness (NPPCD), an initiative of the Union Health Ministry, has introduced free hearing tests, awareness campaigns, and support for cochlear implants in children. In Tamil Nadu, the government covers ₹6.5 lakh for children’s cochlear implant surgeries through its insurance programme.
However, Dr. Ahilasamy points out that hearing aids, though more accessible now, come with their own set of issues. “Government-provided hearing aids are often basic, single- or two-channel models,” he says “It’s like wearing a shoe that doesn’t fit very well. If a hearing aid doesn’t match a person’s specific hearing loss, the sound becomes fuzzy. People give up on using them.”
Hearing loss across generations
The issue however, is not restricted to children: the WHO warns that the prevalence of hearing loss increases with age, among those older than 60 years, over 25% are affected by disabling hearing loss.
“Hearing loss among older adults mirrors the progression of cataracts, here, it is sound, not sight that fades away. When older adults struggle to hear, they start withdrawing from social interactions,” says Ravi Ramalingam, managing director of KKR ENT Hospitals. “They stop participating in family conversations and social events, which leads to isolation.”
According to V. Mohan, chairman of Dr. Mohan’s Diabetes Specialities Centre in Chennai, people with diabetes also face an increased risk of hearing loss due to high blood sugar damaging inner ear nerves and blood vessels. “Many people don’t realise they have hearing loss until it becomes significant. If you often find yourself asking others to repeat what they’ve said, have difficulties hearing in noisy settings, or experiencing sounds that seem muted, it is essential to consult a doctor immediately”, he says
There is also a gap in the support provided by government interventions for groups other than children. “While the government funds cochlear implants for children, adults and seniors are often left out of these programmes,” says Dr. Ravi. “Adults respond better to cochlear implants since they already understand speech and sound, but many cannot afford the high costs. Additionally, hearing aid maintenance is often overlooked”.
Ending the stigma
Architect and XDR-TB survivor Debshree Lokhande experienced hearing loss as a side effect of her tuberculosis medication and now uses a cochlear implant. She emphasises the need for choice-based support. “A lot of the current support is contingent on the finances of the affected person. This needs to change. Also, care should extend beyond medical support and inclusion cannot be an afterthought. She advocates for hearing loss camps similar to free government eye camps. “Why do we so readily donate glasses but hesitate to support hearing aids?” she asks.
Debshree points out everyday, disabled unfriendly issues such as airplane safety announcements being given solely through the audio mode. “Sometimes there is a laminated sheet with printed guidelines, but they are not always placed out,” she says.
The emotional distance that arises due to withdrawal from society can also have severe consequences. “Without mental stimulation from social interaction, the risk of depression and cognitive decline, even dementia rises,” says Dr. Ravi.
Dr. Ahilasamy points out how stigma can prevent seniors from seeking help. “Young people wear Bluetooth headsets proudly, but older adults hesitate to wear hearing aids because they fear the label of disability,” he says. “And that worsens their isolation.”
With early screenings, accessible and affordable hearing aids, and more awareness initiatives, hearing health has to be brought to the forefront of public health discourse, experts emphasise.
Published – March 04, 2025 04:59 pm IST