1. Socioeconomic Status & Permanent Hearing Loss Anne Greville PhD Greville Consulting Auckland, New Zealand Audiological Society of Australia biennial conference Perth, WA May 19, 2006

2. Thanks to… The Deafness Research Foundation of New Zealand for support of the project The National Audiology Centre for access to the deafness database & assistance with sourcing addresses Simon Jellie of e-Spatial for help in geo- coding the data.

3. Why look at SES? Kubba, MacAndie, Ritchie & MacFarlane Is deafness a disease of poverty? The association between socio-economic deprivation & congenital hearing impairment Int J Audiol 43:123-5 (2004) Children in Glasgow born 1985-94

4. Kubba et al, Glasgow

5. Fortnum, Marshall & Summerfield Epidemiology of the UK population of hearing-impaired children, including characteristics of those with & without cochlear implants – audiology, aetiology, comorbidity & affluence Int J Audiol 41:170-9 (2002)

6. Fortnum et al, UK

7. Methodology Hearing impaired & deaf children notified to the National Audiology Centre’s database Limited to children born 1992 – 1999. Children with acquired or unilateral hearing loss & those born overseas excluded.

8. Sample 828 children 696 children with unambiguous addresses 693 children were geocoded into unique meshblocks (approx 100 people) Decile ratings available for meshblocks

9. Socioeconomic Measure NZ Dep2001 Index of Deprivation Salmond & Crampton (2002) Based on: –income employment communication transport support qualifications living space owned home

10. SES Measure: deciles 1-10 (10 most deprived) Fairly even distribution into tenths of total population For children < 15 years, 13% are in decile 10, 8% decile 5 Over 20% of Maori population in decile 10 40% of Pacific Island population in decile 10

11. Birth year

12. Number of deaf children per decile

13. Decile and age (at 2001)

14. Deafness prevalence & deprivation

15. Ethnicity

16. H/Loss moderate or greater

19. Maori deaf children cf Maori population

20. Cause of deafness

21. Cause of deafness among Maori children

22. Household income levels Ethnic groupMean household income ($,000) Asian 51.3 European 50.6 Pacific Island 44.0 Other 41.4 Maori 39.1 Overall 44.9

23. Conclusions In New Zealand, there is no apparent effect of SES on congenital hearing loss for ethnic groups other than Maori Among the Maori children, unknown cause & family history are the major causal factors

24. … and… Does a family history of deafness in Maori mean that the family is more likely to live in a low SES area? Maori deaf/hearing impaired children are more likely to live in a low income household than are deaf children from other ethnic groups.

25. Thank you