Health disparities among Black deaf and hard of hearing Americans as compared to Black hearing Americans

Summary (Abstract)

There is a dearth of literature on health outcomes for Black people who identify as deaf or hard of hearing (DHH). Black DHH individuals generally experience at least 2 types of oppression, racism and audism, both of which contribute to health disparities within the Black and Deaf communities.

Objective: To understand the prevalence of health outcomes in a Black DHH adult sample and compare this to a Black hearing sample.

Method: A descriptive cross-sectional study with primary Health Information National Trends Survey (HINTS)- American Sign Language survey data from Black DHH adults and secondary National Cancer Institute-HINTS English survey data from Black hearing adults.

Black DHH adults and Black hearing adults (18 years or older).

Using NCI's health information national trends survey in American Sign Language and English, self-reported data was gathered for all medical conditions as diagnosed by healthcare providers.

Conclusion: The study showed that Black DHH adults had a higher likelihood for diabetes, hypertension, lung disease, cancer, and comorbidity compared to their hearing Black counterparts.

Black DHH adults are at disparity for certain medical conditions compared to the general Black adult population. Future directions are needed to ensure that anti-racist policies include consideration of people with sensory disabilities. Inclusion of cultural and language needs of Black DHH patients in cultural humility training for healthcare providers is recommended to address health disparity in this population.

Author(s)

Perrodin-Njoku, E., Corbett, C., Moges-Riedel, R., Simms, L., Kushalnagar, P.

Publication Date

2022

Journal

Medicine

Volume

101

Issue

2

DOI

10.1097/MD.0000000000028464
Video Transcript
There is a dearth of literature on health outcomes for Black people who identify as deaf or hard of hearing (DHH). Black DHH individuals generally experience at least 2 types of oppression, racism and audism, both of which contribute to health disparities within the Black and Deaf communities. This published article highlights the health differences among Black DHH Americans and Black hearing Americans and recommendations on how to effectively deliver healthcare to the Black DHH community. The goal of this study is to understand the prevalence of specific health outcomes in a Black DHH adult sample and compare this to a Black hearing sample. Another goal is to cause a ripple effect within the healthcare field based on different recommendations on how to deliver healthcare effectively to the Black DHH community A total of 204 Black DHH adults and 531 Black hearing adults, all 18 years or older, were recruited. This paper is a descriptive cross-sectional study, with primary survey data from Black DHH adults who took HINTS-ASL (Health Information National Trends Survey in ASL). HINTS-ASL was developed from the original English-based HINTS website made by the National Cancer Institute (NCI), under the National Institutes of Health (NIH). Secondary survey data was collected from Black hearing adults who took English-only HINTS. Self-reported data was collected from participants regarding their medical conditions, based on their healthcare provider’s diagnosis. The study showed that Black DHH adults had a higher likelihood for being diagnosed with: diabetes, hypertension (high blood pressure), lung disease, cancer, and comorbidity (having two or more conditions at the same time). Looking at other health conditions, we found no group differences for: heart disease, arthritis, depression, anxiety, and obesity (greatly overweight). Despite the similarity in health insurance rates between the 2 groups, Black DHH participants rated their physicians as having lower patient-centered communication (PCC) skills than Black hearing participants. This study has helped us identify factors that contribute to health disparities between Black DHH and hearing Americans. At minimum, future directions to address health disparities in this population include: Working through community leaders, such as the NBDA (National Black Deaf Advocates), to implement community-driven solutions to improve knowledge about three things: cancer health, screening adherence, and overall care. Tailored curriculum and training for sign language interpreters who interact with Black DHH patients in healthcare settings, which include content such as language and customs specific to the Black DHH community. More research to clarify factors driving disparities between Black DHH and hearing participants in gathered data and being able to identify Black DHH within population studies, instead of pooling Black DHH in the Black group during data curation. Ensuring that anti-racist policies developed include consideration of people with sensory disabilities. Inclusion of the cultural and linguistic needs of Black DHH patients in cultural humility training for healthcare providers. More so, DHH patient education for all health professionals must become a national mandate. Such a mandate will assist with stimulating medical education and training for healthcare professionals to become well informed about the diverse cultural and language needs of not only Black DHH patients but also those from other marginalized groups.