Objective: Severe to profound hearing impairment affects one-halfto three-quarters of a million Americans. To function in a hearingsociety, hearing-impaired persons require specialized educational,social services, and other resources. The primary purpose of thisstudy is to provide a comprehensive, national, and recent estimate ofthe economic burden of hearing impairment.

Methods: We constructed a cohort-survival model to estimate thelifetime costs of hearing impairment. Data for the model werederived principally from the analyses of secondary data sources,including the National Health Interview Survey Hearing Loss andDisability Supplements (1990–91 and 1994–95), the Department ofEducation's National Longitudinal Transition Study (1987), andGallaudet University's Annual Survey of Deaf and Hard of HearingYouth (1997–98). These analyses were supplemented by a review of theliterature and consultation with a four-member expert panel. MonteCarlo analysis was used for sensitivity testing.

Results: Severe to profound hearing loss is expected to cost society $297,000 over the lifetime of an individual. Most of these losses(67%) are due to reduced work productivity, although the use of specialeducation resources among children contributes an additional 21%.Life time costs for those with prelingual onset exceed $1 million.

Conclusions: Results indicate that an additional $4.6 billion willbe spent over the lifetime of persons who acquired their impairment in1998. The particularly high costs associated with prelingual onsetof severe to profound hearing impairment suggest interventions aimedat children, such as early identification and/or aggressive medicalintervention, may have a substantial payback.