Population estimates of the number of adults in the UK with a hearing loss updated using 2021 and 2022 census data

The release of data from the latest UK censuses, conducted in 2022 for Scotland and 2021 for the remainder of the UK, provides an opportunity to update our earlier publication on the population estimates of the number of adults with hearing loss (Akeroyd et al. 2014). As there, our method was to multiply the prevalence data from the National Study of Hearing (“NSH”; see tables B5124-12 to B5124-23 in Akeroyd et al. 2019) by the number of adults from the censuses. The NSH’s prevalence data are banded by decades of age. The England, Welsh and Northern Irish census data are reported year-by-year of age (Office for National Statistics 2023; Northern Ireland Statistics & Research Agency 2022), and so we summed those by NSH age band. The Scottish census, however, has so far only reported data in 5-year bands (Scotland’s Census 2023), and those bands were defined slightly differently to the NSH’s (e.g. 30–34 and 35–39 years versus 31–40 years). To adjust for this difference, we fitted a cubic-spline function to the census data, to interpolate year-by-year values, then summed those by NSH age bands. For consistency with our earlier work we used a hearing loss of 35 dB or more in the better of the two ears (averaged over 500, 1000, 2000, 4000 Hz). For comparison, we also recomputed the numbers from 2011 to cover the whole UK (Office for National Statistics 2013); though the NSH was not conducted in Northern Ireland, in the absence of evidence to the contrary, we assumed its prevalence data were applicable there.

The results are set out in Table 1. The total estimate is 4.6 million adults (aged 18–80) with a hearing level 35 dB or more in their better ear. This is a 17% increase on the earlier value from the 2011 census (Akeroyd et al. 2014), even though the total population aged 18-80 in this age band has only increased by 6%, from 47 million to 50 million. The percentage changes vary dramatically by age band, namely +21%, +7%, +28% for age bands of 50s, 60s, and 70s, respectively. The reason is that the changes by band directly reflect the ageing of two major peaks in UK birth rate, in 1947 and around 1964 (Office for National Statistics 2015). As the population ages, these peaks enter then leave the age bands in the NSH calculations. The 51–60 band in 2021/22 now encompasses the 1960s peak, and the 71–80 band encompasses the 1947 peak, but the 61–70 band has lost the 1947 peak.

Table 1. The expected number of adults aged 18–80 in the UK with hearing losses of at least 35 dB in the better ear, given the prevalence data in the NSH and the total population numbers from the 2011 census and the 2021/2022 census. The numbers are rounded to the nearest thousand. The three right-most columns report the percentage increase from 2011 to 2021/2022.

	NSH		2011 census (UK)			2021/2022 censuses (UK)			% change
	Prevalence		Numbers of people with hearing loss			Numbers of people with hearing loss
Ageband	F	M	F	M	sum	F	M	sum	F	M
18–30	0.6%	0.1%	33,000	6,000	39,000	33,000	5,000	38,000	−2	−3	−2
31–40	1.2%	1.7%	50,000	71,000	121,000	56,000	75,000	131,000	11	5	8
41–60	3.7%	4.3%	173,000	196,000	368,000	160,000	179,000	339,000	−7	−8	−8
51–60	5.3%	10.7%	202,000	399,000	601,000	246,000	480,000	726,000	22	20	21
61–70	13.3%	19.7%	451,000	634,000	1,086,000	484,000	680,000	1,164,000	7	7	7
71–80	38.8%	41.5%	910,000	822,000	1,733,000	1,139,000	1,075,000	2,215,000	25	31	28
Totals			1,820,000	2,128,000	3,948,000	2,118,000	2,495,000	4,612,000	16	17	17

In recent years, there has been an increased interest in a criterion of 20 dB (better ear, across 0.5, 1, 2, and 4 kHz) for calculating the prevalence of hearing loss, e.g., in the Global Burden of Disease (GBD Hearing Loss Collaborators 2021). Figure 1 shows the numbers of people with a hearing loss in the better hearing ear according to this definition. There are 12.3 million in total, or 1 in 4 of the population aged 18-80. The numbers will be much greater still—18 million, or 1 in 3—if those with 20 dB in the poorer ear are also included (c.f. Supplementary Figure A for another example). Many such listeners will have hearing difficulties when listening to noise, sound localisation, etc. even if their better ear has a “normal” audiogram. This analysis highlights just how common numerically small, but still potentially significant to an individual, hearing losses actually are. Indeed, it is sometimes un-appreciated just how likely hearing losses are with ageing for a 20-dB criterion, especially for higher frequencies: for example, the NSH data indicates that it is near-certain (98%) that everyone aged 71-80 will have a hearing level of at least 20 dB in their better ear averaged across 4, 6 and 8 kHz.

Figure 1. Expected number of adults (age 18–80) in the UK with hearing losses of at least 20 dB in the better ear, given the prevalence data in the NHS and the total population numbers from the 2021/2022 census. This does not include adults with asymmetric hearing losses who may experience hearing problems even if better hearing ear is within normal limits.

In our earlier work, we cautioned that all these values could only be estimates, as the prevalence data in the NSH were collected in the 1980s (Davis 1995; Akeroyd et al. 2019). There are multiple reasons why the values may have changed either upwards or downwards – e.g. changes in general health, long-term changes in the economy away from the noisy industry, noise-at-work regulations, lifestyle choices in leisure listening to loud music. Nevertheless, despite its age, the NSH still remains the primary audiological data available in the UK, and therefore is the only data set that detailed calculations can be based on: the UK Biobank used a triple-digit speech-in-noise test (Dawes et al. 2014) while the English Longitudinal Study of Ageing used a screening device set to 1-kHz and 3 kHz (Tsimpida et al. 2020). But, there are both similarities and differences to the latest nationally representative prevalence data in comparable countries. For instance, for the “CONSTANCES” study in France, which was collected between 2011 and 2019, the prevalence-by-age curve for males closely matches those from the NSH, but for females, the French values are almost 10% greater than the NSH’s for 50’s and 60’s (Lisan et al. 2022). The resulting uncertainty as to which way the prevalence of hearing loss in the UK has actually changed since the 1980s emphasises the paucity of current epidemiological data (Whitty 2023) and indicates that a suitable new UK national study of hearing needs to be considered.

Acknowledgements

Both authors contributed equally to the conceptualisation, analyses and writing. This research was supported by the National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre and Manchester Biomedical Research Centre. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care.

Declaration of interest

None.