PP412 - Evaluating Racism and Colorism in U.S. Hearing Aid Design: A 20-Year Longitudinal Analysis

Abstract:
Hearing aid design has a long history of colorism, with hearing aids in the 20th century usually being sold in ‘beige’ colors that are preferrable to people with lighter skin. This longitudinal study evaluated how available hearing aids have been in darker skin colors over the last 20 years in the United States hearing aid market. The colors of all prescription BTE-style hearing aids sold in the USA from 2004 to 2024 were compared to validated scales of human skin color to assess if some skin colors are underrepresented in hearing aids.

Summary:
Rationale
Colorism and racism have been normalized in American society for centuries. Hearing aid design in the 20th century shows many examples of colorism, where people with lighter skin colors are treated as the ‘default’. During this time period, hearing aids were often only sold in beige colors that were meant to be used by people with lighter skin colors. Research has shown that consumers prefer hearing aids that match their skin color because these devices are less noticeable, so lack of access to hearing aids that align with someone’s skin color likely decreases an individual’s willingness to buy and use amplification. Understanding the lack of hearing aid color availability for people with darker skin tones can help clarify the lower rates of hearing aid use by people of color and show the potential for people of color to be disproportionately affected by the negative effects of untreated hearing loss.

Methods
This study evaluates the colors that hearing aids were sold in from 2004 through 2024 and compares hearing aid colors to validated measures of the full range of human skin colors. A list of all hearing aid models sold in the United States from 2004 to 2024 were recorded. Product portfolios, technical specifications, and other documents listing the colors that each hearing aid model were sold in were collected from each company selling hearing aids in the USA. The CIEDE2000 color difference formula was used to compare every color that every model hearing aid was sold in with the Monk, Fitzpatrick, and PERLA human skin tone scales to identify which skin color was most similar to each hearing aid color. After mapping each hearing aid color to its most similar skin color, the distribution of hearing aid skin colors was assessed to determine if hearing aids were equitably available for people across the range of human skin colors.

Results & Conclusions
Based on prior, published work on this topic by this author and early analyses with this data, the results from this study are expected to show that hearing aids in the United States are produced in lighter skin colors more often than in darker skin colors.