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Health Care Decisionmaking

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Distinct communication modes used by deaf adults may be associated with health care use and health status

The age when a person develops severe bilateral hearing loss can have a significant effect on communication and socialization. People deafened after early adulthood and completion of their basic education are more likely to communicate well in English. People deafened prelingually (usually considered to be before age 3), before the development of language, are more likely to communicate using sign language. These distinct communication modes may affect health care use and health status, suggests a study supported by the Agency for Healthcare Research and Quality (HS09539).

Steven Barnett, M.D., and Peter Franks, M.D., both of the University of Rochester, found that prelingually deafened adults' use of health care was similar to that of other language minority groups. Compared with the general population, prelingually deafened adults had fewer physician visits and were less likely to have visited a doctor in the preceding 2 years. Postlingually deafened adults' use of health care services appeared similar to people with chronic illness. Compared with the general population, these deaf adults had more physician visits and were more likely to have visited a doctor in the preceding 2 years. However, postlingually deafened women 50 years and older were less likely to have had a mammogram within the prior 2 years.

Frequency of physician visits may have been high and mammography compliance low because the medical needs of postlingually deafened adults were inadequately addressed. If physicians and deaf patients need to spend more time trying to communicate, there will be less time to discuss recommended preventive services. Their findings were based on analysis of data from the 1990 and 1991 National Health Interview Surveys, the most recent years the Hearing Supplement was administered.

More details are in "Health care utilization and adults who are deaf: Relationship with age at onset of deafness," by Drs. Barnett and Franks, in the February 2002 Health Services Research 37(1), pp. 105-120.

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