Analysis | Why are Republicans more likely to suffer hearing loss?

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We’re embarrassed to admit it, but at first we saw nothing remarkable about the most detailed map of hearing loss we’ve ever seen.

The result of a broad effort funded by the Centers for Disease Control and Prevention, the map revealed that about 38 million Americans have at least some trouble hearing in both ears and that hearing loss is greatest in areas with the oldest populations.

That didn’t shock us, since older folks, particularly men, are at greater risk of hearing loss. But as it turned out, we were just getting started.

The hearing-loss model — led by David Rein, a health-data virtuoso at NORC at the University of Chicago — teases out detailed geographic estimates from hallowed, top-shelf data sets from around the government, including professional measurements of Americans’ hearing from the National Center for Health Statistics, demographics from the Census Bureau’s American Community Survey and Medicare claims. (NORC had help from Johns Hopkins’s Cochlear Center for Hearing and Public Health, the National Center for Hearing Assessment and Management, the American Speech-Language-Hearing Association and Burness.)

About 12 percent of Americans have at least some hearing loss in both ears, the model found. And many of those people have something in common: age. Hearing trouble hounds 35 percent of folks in their late 60s and early 70s, and 73 percent of those age 75 or older.

If we set aside those groups and look only at people between the ages of 35 and 64 — people who have yet to experience most age-related hearing loss but are old enough to have been exposed to a lifetime of aural assault — we saw some new patterns. For example, hearing loss shows up most frequently in communities with more jobs in the natural resources, construction and maintenance industries, which makes sense given the exposure to workplace noise.

It’s also more common in areas with lower population density and smaller minority populations, which again feels right given that White Americans are more than twice as likely to lose at least some hearing as their Black and Hispanic friends.

Given those associations, we weren’t surprised to see that areas with higher hearing loss tend to have higher rates of Republican support. After all, former president Donald Trump dominates the Republican Party and his enduring appeal among blue-collar, White and older Americans has defined American politics for almost a decade now. (Really! He came down the Trump Tower escalator in 2015, and it’s now 2024.)

So, okay, hearing loss appears to be yet another manifestation of the urban-rural divide. At most, we figured these trends merited perhaps a brief mention in one of the Department’s voluminous reports on other fresher topics.

But then we read the paper again and noticed a line we hadn’t clocked before: “those living in rural areas experience higher rates of [hearing loss], perhaps due to potential noise exposure from outdoor work and recreation such as forestry, all-terrain vehicles, and recreational firearms.”

Could gun ownership help explain the partisan divide in hearing loss?

Americans who have fired 1,000 rounds or more face three times the rate of hearing loss as those who have never fired a weapon, according to an analysis of 2011 and 2012 observations from the National Health and Nutrition Examination Survey. It’s a bit lower once you adjust for age and other factors — probably closer to 1.8 times the rate. .

Why are Americans getting shorter?

“If ever there was an epidemic in the hunting community, it’d be hearing loss,” begins former editor Sam Lungren in MeatEater, an outlet that embraces hunting but not the culture wars that often go with it. “When target practice is a way of life, it’s easy to become blasé about earmuffs. When that buck is about to get over the ridge, jamming in ear plugs is the last of our worries.”

That kind of heavy gun use ranked up there with diabetes, heavy smoking and prolonged exposure to very loud noise at work as one of the most significant risk factors for hearing loss in the 2011-2012 data. And it’s not a niche hobby. In 2011 and 2012, 13 percent of U.S. adults were heavy firearms users, meaning they’d fired more than 1,000 rounds, and nearly half said they were exposed to gun noise for their hobby or job.

And gun ownership tilts heavily rightward. As recently as the early 1990s, Democrats were almost as likely to own guns as Republicans, according to the long-running General Social Survey from NORC (an organization that began as the National Opinion Research Center just in time to measure U.S. attitudes toward entering World War II). But a partisan divide has emerged with alacrity. In 2022, 52 percent of Republicans had guns at home, compared with just 28 percent of Democrats.

So, is it possible that the partisan gap in hearing loss is actually a gun-ownership gap? To know for sure, we’d have to map gun ownership, and we don’t have that data. But — and this might honestly be the most depressing fact we’ve learned in a lifetime of data journalism — we do have a very good proxy: firearm suicides.

Most gun deaths in America are suicides, and most suicides in America involve guns. Academics have found gun suicide so pervasive and predictable that it can be used as a reliable measure of gun ownership in an area. While the impulse to kill yourself may be somewhat evenly distributed, guns are not. And firearms make suicide attempts much deadlier.

Overall, fewer than 2 in 20 suicide attempts are fatal — unless they involve a gun, in which case 17 in 20 end in death, according to a recent analysis by Catherine Barber of Harvard University, Philip J. Cook of Duke University and Susan T. Parker, now at Northeastern University.

When we compare a state’s rate of firearm suicide and the rate at which its working-age residents (ages 35 to 64) lose their hearing, we see the strongest relationship of any variable we considered.

“The correlation between firearm suicide and hearing loss may be explained by the fact that firearm suicide is a proxy for rates of firearm ownership, and using firearms exposes gun owners to very high noise levels,” said Michael Siegel, a Tufts University public health specialist who has unpacked the factors driving gun deaths in scores of published analyses.

In keeping with the partisan divide in gun ownership, we found that firearm suicides are almost four times as common in areas with the highest Republican support as they are in Democratic strongholds.

So do partisan gaps in gun ownership contribute to gaps in hearing loss? They must! It’s hard to dispute the sonic effect of exploding gunpowder, or the common failure by kids who grow up shooting deer and whistle pigs (you may know them as ground squirrels) to use perfect hearing protection.

But Rein, the thoughtful data devotee behind the NORC project, had a reminder ready.

“One thing I’ve learned looking at problems in public health over my career is it’s never one thing,” he said, pointing out that gun suicides could relate to other factors that predict high hearing loss, such as small populations and high disability rates among working-age adults.

“It’s usually some combination of factors,” Rein said. “There’s a lot of information that we have about rural health related to less access to care, higher rates of diabetes, hypertension, and general weathering from economic and other stresses across the life span. Probably, these things are interacting with noise exposures, resulting in higher rates of hearing loss.”

Grace Sturdivant, who earned a doctorate in audiology and spent years helping folks regain lost hearing, told us much the same: You can’t draw a direct line from firearm ownership to hearing loss. But after her umptillionth patient said they wished they’d worn earplugs when they were young, Studivant did something the U.S. health-care industry isn’t great at: She pivoted to prevention.

In 2018, Sturdivant founded OtoPro, which specializes in helping folks find fancy hearing protection. She grew up in a hunting family in Mississippi, and hunters make up about 80 percent of her client base (others include law enforcement and musicians).

“Shooting is a massive risk to your hearing,” she said. “There’s no denying that.” Exposure to a single gunshot, which at 140 decibels or higher is one of the loudest sounds we encounter, can cause damage equivalent to hours and hours of riding an all-terrain vehicle or pushing a lawn mower.

Growing up in the ’80s and ’90s, Sturdivant saw a macho resistance to using hearing protection. You’d tease your buddy that he couldn’t handle his gunshots. But that attitude has been consigned to the dustbin of history, she said.

“I see men who spent their whole lives that way who now are very aggressive about what they’re outfitting their children and their grandchildren with when they go into the same situation.” Turning the corner on hearing loss is “going to take time,” she said, “but I can see it happening.”

Hi, friends! The Department of Data craves queries. What are you curious about: Who’s most likely to have tinnitus? Where you are most likely to experience an earthquake? Do immigrants seek out familiar climates in their new homes? Just ask!

If your question inspires a column, we’ll send you an official Department of Data button and ID card. This week’s button goes to Bonnielin Swenor, the Johns Hopkins University disability data advocate who put us in touch with the team working on hearing loss.



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