hearing is living

HEARING IS LIVING

A STUDY BY HEAR THE WORLDHear the World is a global initiative, launched in 2006, byleading hearing instrument manufacturer Phonak createdto raise awareness about the importance of hearing. Theinitiative calls attention to the social and emotional impactof hearing loss and addresses prevention of and solutionsto a problem that affects more than 16% of the world’spopulation. Bryan Adams, Annie Lennox, Lenny Kravitz,Plácido Domingo and other renowned personalities support the Hear the World Initiative as ambassadors. Inthe context of the Hear the World Initiative, Phonak hasestablished the non-profit Hear the World Foundation toimprove the quality of life of people with hearing lossthrough financial and technical assistance. The foundationis committed to the prevention of hearing loss as well asthe support of people with hearing loss and their families.

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www.hear-the-world.com

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ABOUT HEAR THE WORLD

EN 037-0154-02

HEARING IS LIVING A STUDY BY HEAR THE WORLD

List of contents

Editorial 2Methodology 4The survey participants 6Hearing loss and hearing aids 8The significance of hearing in various aspects of life 12The relatives’ perspective 14Looking for partners and partnership 16Family and friends 22Sports and leisure 24Travel and everyday mobility 26Health and wellbeing 28Publication details 30Glossary, legal notice 32

HEAR THE WORLD_STUDIE_EN_HEAR THE WORLD 13.12.11 17:17 Seite 1

EDITORIALA STUDY BY HEAR THE WORLD

Hearing accompanies us throughout our lives; it shapes and influencesevery part of our world. Hearing enables us to communicate with others.Sounds are there with us in our daily life – some relax us, others causestress. Much of what we hear we enjoy. There are everyday sounds we nolonger even notice, and other noises we would rather just avoid. We needour ears to communicate with other people, and when we want to listen tomusic or make music ourselves.

But these are only the better-known facets of the subject. On the occasionof the fifth anniversary of the founding of the Hear the World initiative, wecommissioned a large study to shed light on the lesser known aspects ofhearing. In all, we surveyed over 4,000 people in five countries, on diversetopics related to hearing in all areas of life. In addition, we asked expertsfrom relevant specialist areas for their assessment of the study results, andonce again reached the conclusion: Hearing is Living!

For example, did you know that our hearing is partly responsible for howwell we sleep at night, how often we exercise, where we go on vacation or

2 HEARING IS LIVING


HEARING IS LIVING 3

how attractive we think we are? Or would you have thought that the qualityof our hearing also affects our personal relationships? Or how happy we arein partnerships? Our study shows that more than one in three hearing aidusers believe that their love lives have improved since having their hearingloss treated with a hearing aid, and 81 percent of partners and spouses alsosay: “I am glad that my partner wears a hearing aid.”

I am pleased to be able to present some of the exciting results of our studyin this brochure and we hope that reading it will lead you too to conclude:Hearing is Living!”

I hope you will find it enjoyable and stimulating to read.

Yours, Maarten Barmentlo Group Vice President Marketing, Sonova Holding AG


4 HEARING IS LIVING

4.335 people from 5 countries were surveyed in this study


HEARING IS LIVING 5

METHODOLOGYA STUDY BY HEAR THE WORLD

What significance does hearing have on various aspects oflife? How important is hearing for relationships with part-ners, with friends and family, or at work? What bearingdoes it have on how we spend our leisure time, and howdoes it affect our health and well-being? We focused onquestions such as these in the design of this study.

In terms of methodology, the present study, “Hearing isLiving”, consists of two parts. The starting point was aninternational online study involving large numbers of participants. A total of 4,335 people in five countries, aged45 years and upwards, were surveyed: 867 people(weighted) per country in Germany, Switzerland, France,the UK and the USA (see Figure 1). In a second stage,renowned experts from relevant specialist areas wereasked to comment on the study results.

The aim of the survey was to explore the importance ofhearing in different areas of life. In order to find out what effect hearing has in various contexts, one group ofrespondents were people who were especially involvedwith the topic of “hearing” because they themselves areaffected by hearing loss. A further distinction was madehere between respondents with and without hearing aids

(“owners” and “non-owners” of hearing aids). A group ofpeople with normal hearing served as a comparison group(“control group”). And in order to find out something aboutthe signifi cance of hearing within families and partnerships,a fourth group was surveyed: close relatives of people withhearing loss. For the purposes of the study, “close relatives”were defined as partners, children, parents or siblings.

All four groups were asked some of the same questions,and some questions that covered the same ground. From the different responses given by the four groups, we can assessthe relative significance of hearing. What is espe ciallyinteresting here is the comparison of the two groups “witha hearing aid” and “without a hearing aid” – this is the areawhich highlights the difference between cases of correctedand untreated hearing loss.

4.335Total

854USA

862UK

866Germany

856Switzerland

897France

• online survey • time frame: Sept 23rd – Oct 11th, 2011• LOI approx. 25 minutes• 4,335 respondents ages 45 and up• number of respondents (weighted): 867

FIGURE 1: METHODOLOGY


6 HEARING IS LIVING

Let us look more closely at the four sub-groups in the“Hearing is Living” study (see Figure 2).

Group 1 consisted initially of 985 people who stated thatthey are affected by hearing loss and have a hearing aid.For the subsequent evaluations, however, a total of 70were excluded who admitted that while they owned a hearing aid, they “virtually never” wore it. This leaves atotal of 915 people in group 1 (“owners”). Of these, 15%have had their hearing aid for only a few months, 38%have worn one for two to five years, and around half therespondents in this group have had their hearing aid formore than five years. More than two thirds of the respon-dents (68%) wear their hearing aids every day or almostevery day, if not always for the whole day. A further 11%wear their hearing aids “several times a week”. In terms ofthe type of hearing aids used, the overall finding across allthe countries in the survey was that around two thirds ofrespondents wear behind-the-ear devices (67%), just undera third wear in-the-ear devices (30%), and 2% have optedfor implants. Considerable differences can however beobserved between the various countries – the incidence ofin-the-ear devices ranges from 17% in Germany to 50% inthe USA, and the proportion of implants varies between 4%in France and 0.3% in the USA.

68% wear their hearing aid “every day”

or “almost every day”n = 985 surveyed hearing aid owners

50% of respondents with hear ing loss but without a hearingaid had not yet seen a doctor about it

n = 1,137 respondents with hearing loss but without a hearing aid

THE SURVEY PARTICIPANTSA STUDY BY HEAR THE WORLD


HEARING IS LIVING 7

The second group (“non-owners”) consisted of a total of1,137 participants. In response to the question of how theywould assess their own hear ing, just under one fifth ofrespondents (18%) reported that they had not themselvesnoticed any change in their ability to hear, but other peoplewould occasionally remark that they no longer seemedable to hear very well. 50% had noticed that their hearingwas no longer as good as it had been, but had not yet seena doctor or hearing care professional about it. 22% statedthat they had seen a doctor or hearing care professional,who advised them that a hearing aid was not yet necessary.And finally, 15% of the respondents in group 2 actually hadbeen advised to wear a hearing aid to compensate for theirfailing hearing, but for various reasons had not yet takenthe decision to do so.

In group 3, “relatives”, a total of 1,104 people were sur-veyed. This group could hear well themselves but had aparticular interest in the subject of hearing and hearingloss because they had family members affected by hearingloss. In most cases the person affected by declining hear -ing was a parent (56%), for 10% it was a brother or sisterwho was affected. In 5% of cases it was their own child,while for just over one third of respondents it was the partner or spouse who was affected (36%). Slightly lessthan half the affected family members had a hearing aid (46%).

To place the responses of the three groups in context, acontrol group was also included in the survey. The 1,109participants in this sub-sample match the age and sex profile of internet populations aged 45+ in the countriescovered. They are not affected by impaired hearing and do not have a relative with hearing loss – so their answersrepresent the views of the general population over the ageof 45 in these countries.

Group 1:

HI OWNERS

• hearing loss

• owner of a hearing aid

they wear at least

occasionally

• n (HI) = 915

Group 2:

HI NON-OWNERS

• hearing loss, self noticed

or diagnosed

• do not own a hearing aid

(n = 1,137) or own a

hearing aid, but wear it

“virtually never” (n = 70)

• n (no HI) = 1,207

Group 3:

RELATIVES

• no hearing loss

• have someone close to

them who suffers from

hearing loss, e.g. a spouse,

parent, sibling or own

child

• n (relative) = 1,104

Group 4:

CONTROL GROUP

• no hearing loss

• no close relative with

hearing loss

• no special connection to

the topic of hearing loss

• n (control) = 1,109

FIGURE 2: DEFINITION OF SUBGROUPS


8 HEARING IS LIVING

49% “I shouldhave started using a hearing aid

much earlier.”237 hearing aid owners in the age group 45-64 years,

percentage of top 2 boxes


61.3%“Hearing aidsare too expen-

sive.”

FIGURE 3: STATEMENTS OF HI OWNERS (GROUP 1)FIGURE 4: REASONS FOR NOT WEARING A HEARING AID (GROUP 2, NON-OWNERS)

81.2%“I wear my hearing aid

quite openly, it’s nothing to be

ashamed of.”

67.6%“I can’t imaginebeing without

my hearing aids again.”

76.5%“Other peoples’reactions to myhearing aid are

generally positive.”

19.9%“I would beembarrassed

to wear a hearing aid.”

11.1%“I want to

avoid negativereactions of

other people.”

17.4%“I don’t think a hearing aid

helps verymuch.”

HEARING IS LIVING 9

HEARING LOSS AND HEARING AIDS A STUDY BY HEAR THE WORLD

What is it like to live with a hearing aid? Why do some

people use them – and why do other people decide against

a hearing aid, even if they clearly notice that their hearing

is no longer perfect?

Most of the hearing aid users surveyed in the study feelvery comfortable with their hearing aid. A total of justunder two thirds (63%) of all respondents in group 1agree or strongly agree with the statement “My hearingaid(s) have become an essential aspect of my life. I evenforget that I am wearing them.” In Switzerland the figureis as high as 69%, and in Germany 73%.

Eight out of ten hearing aid owners state that they weartheir hearing aid quite openly – after all, a hearing loss isnothing to be ashamed of. A good three quarters of hear ingaid owners report generally positive reactions to their hear -ing aid (77%) and over two thirds (68%) say that they wouldnot want to do without their hearing aids (see Figure 3).

In all, 40% of respondents regret in retrospect that theydid not opt for a hearing aid much earlier – in the 45–64age group, as many as half the sample say they shouldhave started using one much earlier.

So why do so many people hesitate when it comes to re -storing their own hearing? It is interesting that financialreasons appear to play the biggest role in the decisionagainst a hearing aid. The view that a hearing aid “doesnot help very much” is held by only 17% of respondentswith hear ing loss but without a hearing aid – implying that83% believe that a hearing aid would certainly help them.Only about a tenth of respondents in this group (11%) saythat they want to avoid negative reactions from otherpeople. 20% state that they would find it embar rass ing to wear a hearing aid – they would not want everyone to know that they could not hear very well. By far thegreatest level of agreement is expressed, by 61%, with thestatement “hearing aids are too expensive” (see Figure 4).

n (HI) = 915 Percent of top 2 boxes (strongly agree, agree)

n (no HI) = 1,207Percent of top 2 boxes (strongly agree, agree)

“WHICH FACTORS WOULD MAKE YOU OPT FOR A HEARING AID?”

HL becomes worse 78.6

Hearing care professional /doctor recommends HI 66.1

HI fully reimbursed or free 47.3

Partner /close relative asks me to 41.3

HI become cheaper 29.1

Financial situation improves 11.4

Recommendation of acquaintance 9.6

Press/TV/ internet 7.8

Employer asks me to 4.7

Advertising 2.9

Testimonial / celebrity 1.1

FIGURE 5: FACTORS TO OPT FOR A HEARING AID (GROUP 2, NON-OWNERS)

n (no HI) = 1,207 Percent top 2 boxes (strongly agree, agree)


10 HEARING IS LIVING

56% “My hearing aids were a worthwhile purchase.”

915 hearing aid owners, percentage of top 2 boxes


HEARING IS LIVING 11

HEARING LOSS AND HEARING AIDSA STUDY BY HEAR THE WORLD

Another possible reason is identified by Professor Dr.Martin Ohlmeier, specialist in neurology, psychiatry andpsychotherapy, and Director of the Ludwig Noll hospital inKassel (Germany): “Getting used to change, in this case theloss of hearing, is almost always accompanied by a certainresistance. For adults in particular, it is very difficult to get used to new situations and to adjust one’s life. Evenpositively anticipated changes, such as the prospect ofimproved hearing, can cause stress. This may explain whymany affected people often wait far too long to acquire ahearing aid.”

Against this background, it would be interesting to knowwhat would persuade the respondents from group 2 to optfor a hearing aid after all. Figure 5 (page 9) shows thataround two thirds (66%) could accept the idea of a hearingaid if their doctor or hearing care professional recom -mended it. 41% could imagine using a hearing aid if theirpartner or a close relative asked them to. As many as 79% ofrespondents in group 2 say that they would wear a hearingaid if their hearing loss got worse – and here they may wellbe underestimating how much a hearing aid could improvetheir quality of life, even in a case of mild hearing loss.

And of course financial factors play their part: almost onein two people (47%) might opt for a hearing aid if theirhealth insurance paid for it in full, or if it were free ofcharge for some other reason. Cost was a major factor forrespondents in the USA and France especially. In all, 29% of respondents state that cheaper hear ing aids over-all would be attractive to them. 11% are wait ing for theirfinancial situation to improve.

By contrast, hearing aid owners do not regret opting for ahearing aid, even taking the financial side into account:across all countries, 56% of hearing aid owners are of theview that getting a hearing aid was definitely worth it. Inthe USA, as many of 72% of respondents agree with thisstatement, as do 66% in Switzerland and 63% in Germany.

“My wife and I have had lengthy discussions about why I waited so long to buy a hearing aid. Was it vanity? Probably most of all I was unaware of how much quality of life a hearing aid would give back to me.”

Dr. Ulf Berg, president of the board of directors of several international companies (Switzerland)

“My husband even says that my hearing aids are one of the best purchases we have ever made.”

Tanja Buelter, journalist and TV presenter (Germany)

“As a global community, we happily use iPods, mobile phones or Bluetooth headsets all the time because we are told that these are aspirational and desirable items to own.Even though we embrace this technology, hearing aids – which are smaller, more technologically advanced and in some cases invisible – are not used to the same degree.Why? It can’t be stigma because we are so used to seeing people wear things on theirears. Could it be that we have an old fashioned, subconscious view of how someone with hearing loss is viewed by others?”

Robert Beiny, Audiologist (UK)



Hearing is an important part of our lives – so it is obvious

that any worsening in hearing has very direct effects on the

most diverse areas of life. That people with declining hear -

ing find it increasingly difficult to follow dialogues on TV,

radio or in the theater, that outings to restaurants suddenly

be come a challenge because they can no longer make out

what their companion is saying in the hubbub of voices,

that hearing loss can also lead to problems at work – all this

is known. But hearing loss has other consequences over

and above these, including in areas of life that might not

be immediately apparent.

Figure 6 shows the parts of their lives in which respondentswithout a hearing aid perceive some worsening since theirhearing has declined (top 3 boxes). It can be clearly seen inthe graphic that the greater the perceived deterioration, themore serious the (untreated) hearing loss is. But even peoplewho rate their hearing loss as “mild” sometimes notice clearnegative changes. Around a quarter of all respondents(26%) state that they have noticed a reduction in theirgeneral quality of life. Of those respondents who assesstheir hearing loss as “moderate” or “severe”, as many asone in two confirm that their general quality of life has

been impaired. But hearing loss also has negative effects onreceptiveness and mental fitness (mentioned by 25%), onfriendships and activities with friends (22%), on the senseof self esteem (21%), feeling of security, or the relationshipwith one’s partner (each 20%). And last but not least: 14%of respondents without hearing aids report that hearing losshas negative effects on their love life – amongst respondentswith more than just mild hearing loss it is as high as 23%,so almost one person in four.

The solution to the problem is close at hand, as the studyclearly shows – 36% of hearing aid users report that theirlove life has improved since they have had a hearing aid.64% report that the hearing aid has a positive influence ontheir self-confidence. Around 70% state that their mentalfitness, their general mood and their relationship with theirpartner have improved. 78% have had more fun in sharedactivities with their friends since they have been wearinga hearing aid, 73% have better rela tionships with theirfamily, and 83% believe that their hearing aid has a posi-tive influence on their overall quality of life (top 3 boxes forall statements, see Figure 7).

36% of hearing aid users state that their love life has changed for the better since they have been wearing a hearing aid915 respondents with a hearing aid, percentage of top 3 boxes

78% of hearing aid users enjoy shared activities

with friends more since they have been wearing a hearing aid

915 respondents with a hearing aid, percentage of top 3 boxes



THE SIGNIFICANCE OF HEARING IN VARIOUS ASPECTS OF LIFEA STUDY BY HEAR THE WORLD

FIGURE 6: ASPECTS OF LIFE(GROUP 2, NON-OWNERS)

“HOW MUCH OF A POSITIVE IMPACT HAVE HEARING AID(S) HAD IN VARIOUS ASPECTS OF YOUR LIFE?”

General quality of life 83.1

Friendships, activities with friends 77.7

Events (movie theater, theater, concerts, etc.) 73.4

Relationships with family members 72.5

Going out (e.g. restaurants) 71.2

Feeling of security 70.6

Relationship with partner 69.7

General mood, frame of mind 69.3

Receptiveness, concentration, mental fitness 69.3

Sense of independence 66.9

Traveling (e.g. holiday travel, business trips) 65.6

Everyday mobility (e.g. road transport, public transport) 64.5

Self-esteem 64.2

Sporting activities 44.4

Career 43.9

Physical health (e.g. heart and circulation, weight) 38.3

Love life 35.5

FIGURE 7: ASPECTS OF LIFE (GROUP 1, HI OWNERS)

n (HI) = 915. Percent top 3 boxes (a little /significantly /very much so)

“WOULD YOU SAY THAT YOUR LIFE HAS CHANGED FOR THE WORSE IN THESE AREAS SINCE YOU HAVE BEEN UNABLE

TO HEAR SO WELL?”

Events

General quality of life

Receptiveness, concentration, mental fitness

Going out (e.g. restaurants)

Friendships, activities with friends

General mood, frame of mind

Self-esteem

Feeling of security

Relationship with partner

Relationships with family members

Physical health (e.g. heart and circulation, weight)

Career

Sporting activities

Traveling (e.g. holiday travel, business trips)

Sense of independence

Love life

Everyday mobility (e.g. road transport, public transport)

n (no HI) = 1,207. Percent top 3 boxes (a little /significantly /very much so)

52.322.4

18.5

19.7

16.7

14.3

16.6

14.9

15.7

14.8

11.8

14.6

12.0

13.1

10.1

10.0

11.5

9.7

50.5

44.4

43.2

47.2

39.2

42.3

34.6

37.2

38.0

27.9

35.4

30.6

29.3

28.2

23.0

27.6

22.0%

29.4%

26.0%

25.4%

22.9%

21.9%

21.3%

20.1%

20.0%

17.9%

17.7%

17.4%

17.1%

14.6%

14.3%

14.2%

13.9%

mild hearing loss

moderate/severe hearing loss

total, group 2



58% “My relative has been having a better life since he has been wearing a hearing aid.”432 respondents whose relative wears a hearing aid,


41% “My own life is easier now that my relative wears a hearing aid.”432 respondents whose relative wears a hearing aid,




THE RELATIVES’ PERSPECTIVEA STUDY BY HEAR THE WORLD

Hearing loss generally affects not only the sufferers them-

selves, but also their families. We asked family members:

“Would you say that your own life has changed for the

worse since your relative has been unable to hear so

well?” And indeed in each case, 29% of relatives report

negative effects on their own activities with friends, and

on their general mood.

A quarter of the relatives surveyed (26%) noticed a declinein their own overall quality of life, 18% a worsening intheir own self-confidence and their own health (top 3boxes for all statements). Hearing loss in one’s partner hasa more severe effect on wellbeing than if a parent or sibling have the problem. If we look only at those respon-dents in group 3 whose spouse is affected by hearing loss,we notice that especially the relationship is put understrain: around 42% of the respondents reported that theirpartner’s hearing loss had negatively affected their relationship. But also their own activities with friends,their own ability to concentrate, and their general moodsuffered as an effect of their partner’s hearing loss (around34% of responses, top 3 boxes).

Professor Dr. Martin Ohlmeier, specialist in neurology,psychiatry and psychotherapy in Kassel (Germany), confirmsthese results: “Relatives rightly have a claim to be able,and be allowed, to communicate with their partner orfamily member. In practice, it is not uncommon for conflictto arise when the relatives can no longer put into practicewhat is necessary to maintain the relationship they havebeen used to sharing. To put it another way: the partnerhas a right to an acceptable level of communication in therelationship.”

No wonder that amongst those respondents whose relativedoes not yet wear a hearing aid, one in three believes thattheir own lives would be easier if the affected family mem-ber could make up their mind to get one (29%). That theyare probably right to think so is demonstrated by lookingat those respondents whose relatives already have a hear -ing aid: they confirm that getting the hearing aid not onlyhad a positive effect on their relative’s life (58%), but alsodirectly improved their own life (41%).

“In the end, it was my husband who asked me to finally do something about my hearingloss. He was after all the one who bore the brunt of it. He was constantly having to repeatthings he had said, and time and again there were misunderstandings. When we hadarranged to meet, sometimes I would be standing at the wrong place at the right time,and sometimes at the right place at the wrong time.”

Caroline Roth, former domestic science teacher, now housewife and mother of two children (Switzerland)

“I have two lovely girls aged 4 and 23 months old. I’d never hear them cry during thenight and as a result my wife would end up seeing to them. The sleep deprivation for mywife did not help our relationship.”

Allen Reid, employee in the credit division of an automotive manufacturer (UK)

I have been wearing hearing instruments for 20 years and I have to say that my life has changed. My wife, Anne, no longer has to serve as my hearing assistant. I can hearpeople at social outings and at business meetings. I also hear our grandchildren whenthey call, “Grampie”.

Jim Ryun, founder and president of a public relations company and former congressman (USA)



52% of hearing aid users

state that they find it easy to make new

acquaintances – just as many as in the

general population



LOOKING FOR PARTNERS, AND PARTNERSHIPA STUDY BY HEAR THE WORLD

It is probably one of the most common prejudices about

hearing aids: they are a hindrance if you want to get to

know someone.

Amongst those with hearing loss who have not yet opted fora hearing aid (group 2), across all the countries 19% ofrespondents hold this view. The vote is particularly clear inthe USA – here, one in three fear that it may be difficult to make new acquaintances. In the UK, the figure is justunder one in four (24%), in France 15%, in Germany 12%and in Switzerland 11% of respondents worry that wearinga hearing aid will make it harder to meet someone (top 2boxes for all statements, see Figure 8, page 18).

What is the real truth about this prejudice? In the “Hearingis Living” study we wanted to get to the bottom of it. First,we were interested in the experiences of hearing aid wearers themselves. The result: more than half (52%, top2 boxes) of hearing aid owners report that they find it easyto make new acquaintances. Since 52% of respondents inthe control group also said they had no problems getting toknow people, there is no difference between hearing aidowners and the general population.

We wanted to find out more, and asked: “Have you had arelationship break down because of the hearing aid?” Only3% of hearing aid users answered “yes” to this question.In comparison, in the group of non-users also 3% ofrespondents state that a previous relationship had brokendown – albeit not because of a hearing aid, but because of their hearing loss.

To cover the subject of getting to know people and partner-ships from all angles, we couldn’t ignore the partners inthe relationship – after all, they have their own opinions onthe question “hearing aid: yes or no”? And their opinion isclear: 41% of those respondents whose partner or spouseis affected by hearing loss, but does not yet wear a hearingaid would be glad if their partner would get one. Just underone in five (19%) even believe that getting a hearing aidwould improve their relationship.

81% of partners and spouses say:

“I am glad that my partner wears a hearing aid.”

Respondents whose spouse or partner wears a hearing aid,





FIGURE 8: PREJUDICE (GROUP 2, NON-OWNERS)

n (no HI) = 1,207. Percent top 2 boxes (strongly agree/agree)

19.1%Total

33.2%USA

24.2%UK

12.3%Germany

15.0%France

10.6%Switzerland

“HEARING AIDS ARE A HINDRANCE WHEN YOU WANT TO GET TO KNOW SOMEONE.”

FIGURE 9: STATEMENTS (GROUP 3, PARTNER)

n = 100 (relative = partner, wears HI). Percent top 2 boxes (strongly agree/agree)

81.0%“I am glad that

my partner wears a hearing aid.”

40.0%“I receive more

attention from my partner since he

has been wearing a hearing aid.”

37.9%“Our relationship

has improved since my partner has been wearing a hearing aid.”



94% “In principle, I think glasses area positive thing – if wearing glasses means youcan see better, you should definitely wear them.” 1,109 respondents from the control group, percent top 2 boxes (strongly agree/agree)

92% “In principle, I think hearing aids are a positivething – if wearing hearing aids means you canhear better, you should definitely wear them.”1,109 respondents from the control group, percent top 2 boxes (strongly agree/agree)

FIGURE 10: STATEMENTS

HI-ms (n = 695) no HI-ms (n = 282)

“I FEEL ATTRACTIVE AND DESIRABLE.”

“I OFTEN RECEIVE COMPLIMENTS.”

Percent top 2 boxes (strongly agree/agree) Control group: 27%

Percent top 2 boxes (strongly agree/agree) Control group: 35%

29.1% 15.7%

27.9% 22.1%




And what about those respondents whose partner or spousehas already opted for a hearing aid? For them, things areeven clearer. A resounding 81% confirm: “I am glad thatmy partner wears a hearing aid.” 40% report that theyreceived more attention from their partner since he or shehas had a hearing aid. And 38% think that they now havea better relationship (see Figure 9, page 18).

The study also shows that there is no need to worry aboutbeing attractive: almost a third of hearing aid owners withmoderate to severe hearing loss say that they feel attractiveand desirable (29% agreement in the top 2 boxes), whilstin the comparison group without hearing aids only half asmany respondents (16%) agree with this statement. Andthe hearing aid owners feel just as attractive and desirableas the control group (27%). Such a positive inner attitudeis bound to show on the outside, and 28% of respondentswith hearing aids report that they often receive compliments.Of the group who have not yet opted for a hearing aid, thefigure for those who state they often receive complimentsis only 22% (in each case, respondents with moderate tosevere hearing loss, top 2 boxes. See Figure 10, page 18).

Spouses and partners also believe that a hearing aid doesnot detract from their partner’s attractiveness: seven out often respondents (70%) whose spouse or partner has hearingloss but has so far done without a hearing aid would notfind their partner any less attractive if he or she were towear one. This is echoed by the partners of the hearing aidowners, of whom 71% agree that: “My partner is not lessattractive to me because he wears a hearing aid” (seeFigure 11).

It is not just those study participants confronted with thesubject of hearing loss because their partner is affectedwho are completely open to hearing aids. Those respon-dents who have no close connection with the topic of “hea-ring and hearing loss” – the control group – also havemuch less anxiety about contact than affected people seemto fear. (See Figure 12).

FIGURE 11: STATEMENTS (GROUP 3, PARTNER)

FIGURE 12: THOUGHT EXPERIMENT (CONTROL GROUP)

RELATIVE = SPOUSE, NOT WEARING

HEARING INSTRUMENT

n = 278 (relative = partner wears no HI) Percent top 2 boxes (strongly agree/agree)

RELATIVE = SPOUSE, WEARING HEARING INSTRUMENT

n = 101 (relative = partner, wears HI) Percent top 2 boxes (strongly agree/agree)

71.3%“My partner is

not less attractive to me because

he wears a hearing aid.”

70.0%“I would not find

my partnerless attractive

if he wore a hearing aid.”

78%of thecontrol group say it

would not be a deterrentto start a relationship

with a person wearing ahearing aid

n = 1,109 (control) Percent bottom 2 boxes (would not bother me/would not bother me at all)



“My ten-year career as a model was very positive. I have gained self-confidence, I talkquite normally to everyone, and I find it easy to make friends.”

Yoya Vallée, model and mother (France)

Within the framework of the “Hearing is Living” study, we carried out a small thought experiment with therespondents from the control group. We asked them: “Ifyou were single and want ed to get to know someone, what would be a deterrent to starting a relationship with this person?”

The result: if the person in question wore glasses, that would be a hindrance to a relationship for 2% of thecontrol group. If they wore a hearing aid, that would be a deterrent for 9%. However, if the person in question did not wear a hearing aid but definitely could not hearwell, that would definitely deter 24%, or one in fourrespondents. Female respondents in particular show afirm opin ion here: entering into a relationship with a manwho does not hear well but does not wear a hearing aid would be completely out of the question for 28% of the women.

And for the sake of completeness, the other side of thecoin: 78% of respondents in the control group would nothave a problem with starting a relationship with someonewho wears a hearing aid (see Figure 12).

What does all this mean for our previous theory that:“Hearing aids are a hindrance when you want to get toknow someone”? The study results allow only one conclu-sion: in the search for a partner, quite evidently neitherhearing loss nor hearing aids themselves represent a hin-drance – it is much more likely just to be your own feelingof insecurity that stands in the way.

These days, a hearing aid is just as natural as glasses, thestudy clearly shows. A total of 94% of the control groupagree or strongly agree with the statement “In principle, I think glasses are a positive thing – if wearing glassesmeans you can see better, you should definitely wearthem”. Almost as many, namely 92% of respondents, believe: “In principle, I think hearing aids are a positivething – if wearing hearing aids means you can hear better,you should definitely wear them.”



“No man is an island”, said the English poet John Donne

back in 1624 – people are not meant to make their way

through life alone. We need other people to interact with,

share our thoughts, and do things with. Family and friends

undoubtedly play a particular role here. It is in the family

and the circle of close friends that we feel particularly at

ease and secure, and in which we can be ourselves. And

here it is all the more important that we understand one

another – in the truest sense of the word – and that there

are no unnecessary misunderstandings.

It is no wonder therefore that hearing loss in a familymember is a subject that can concern a family greatly:23% of relatives of people with hearing loss but without a hearing aid report that the hearing loss is a frequentsubject of conversation in their family. 29% try often orvery often to persuade their relative to wear a hearing aid.

Sometimes no great persuasion is necessary; sometimesthe family itself provides the necessary nudge. Tanja Buelter,a well-known German journalist and TV presenter, describesthe moment when she decided to do something about herhearing loss: “I generally have difficulties in busy places

with a lot of people, where I often cannot tell the directiona voice or a noise is coming from. One day, my three-year-old son called for me from the crowd, I turned in the wrongdirection, and lost sight of him. At that moment I knew thatthings could not go on like this.”

Once the hearing loss has been corrected, not only doesnormality quickly return, but also enjoyment of sharedactivities. 62% of hearing aid owners report that theirhear ing loss is no longer an issue among family andfriends since they have been wearing a hearing aid. 86%feel they are accepted by their friends just as they are.74% keep close contact with their family and 73% enjoydoing things with their friends (see Figure 13).

Even severe hearing loss need not be a reason to do with -out activities with friends, as is shown by the followingfigure: around 41% of hearing aid users with moderate tosevere hearing loss say that they have a large circle offriends. Of the respondents with moderate to severe hearing loss but without hearing aids, only 27% agreedwith this statement.

86% of hearing aid users feel that their friends accept them as they are915 hearing aid users, percentage of top 2 boxes



FAMILY AND FRIENDSA STUDY BY HEAR THE WORLD

“My relationships with my friends and family have become better because I can be moreinvolved in noisy evenings – previously, I would simply withdraw. That is no doubt asubtle area, but maybe the most important. Today I enjoy being in company again.”

Dr. Ulf Berg, president of the board of directors of several international companies (Switzerland)

“My hearing aids make me better company. I used to really talk over people. Because Icouldn’t hear what they were saying I’d do all the talking and I’d interrupt them withoutknowing. I’m far less irritating now!”

Sarah Reygate, Celebrity Make-Up Artist (UK)

FIGURE 13: STATEMENTS “FAMILY AND FRIENDS” (GROUP 1, HI OWNERS)

n (HI) = 915. Percent top 2 boxes (strongly agree/agree)

85.5%“Friends accept

me as I am.”

41.6%“I have a large

circle of friends.”

74.1%“I keep in

close contact with my family.”

73.3%“I enjoy doing

things with my friends.”



70% “Wearing a hearing aidduring sporting activities is no problem at all.”915 respondents with hearing aid, percentage of top 3 boxes

37% “Since I have been wearing my hearing aid, I have enjoyed sports more.”915 respondents with hearing aid, percentage of top 3 boxes



LEISURE AND SPORTSA STUDY BY HEAR THE WORLD

Often it is the little things – you only notice how much you

missed them when they suddenly come back. “When I

went for a walk in the woods, I often thought that maybe

there just happened to be no birds that day”, says one

affected woman, for example. “These days, I am just happy

when I hear birds singing.”

Not being able to hear nature properly, not being able to hear birdsong, the drumming of rain and the sounds ofthe sea, is perceived by three in ten respondents withuncorrected hearing loss (28%) as stressful or very stress-ful. By contrast, two thirds of respondents with hearingaids (66%) report that, thanks to their hearing aids, theycan truly appreciate nature in full once more. More thanhalf of respondents with hearing aids (55%) are happy thatthanks to the hearing aid, they can once again do what everthey like in their free time (see Figure 14).

Choosing how to use your spare time often means being ableto play sports. While a surprisingly high proportion of non-wearers think that you cannot exercise with a hearing aid(see Figure 15) – across all the countries surveyed, more thana quarter hold this view and in Germany it is even a third –

the opposite is the case. In fact many modern hear ing aidsare resistant to water and sweat, and even top athletesthink nothing of wearing a hearing aid during training orcompetitions. So it’s no surprise that seven out of ten hearing aid users (70%) confirm that wearing a hearingaid during exercise is no problem for them at all. Morethan a third of respondents also enjoy sports more sincethey have been wearing a hearing aid (37%).

And along with enjoyment, they also evidently gain endurance: amongst respondents with moderate and severe hearing loss, those with a hearing aid take part in sport or exercise more frequently than those withoutone: one in three hearing aid users (33%) say that theyactively take part in sports at least once a week, but thefigure is only one in four (25%) for non-wearers.

Regardless of the severity of the hearing loss, respondentswith hearing aids also play sports with other people more frequently (e.g. with friends, family or other trainingpartners) than respondents without hearing aids (50% vs. 43%)

n (no HI) = 1,207 Percent top 3 boxes (partly agree/agree/strongly agree)

27.5%Total

22.8%USA

26.0%UK 35.7%

Germany27.5%France

25.3%Switzerland

FIGURE 14: STATEMENTS “LEISURE”(GROUPS 1 AND 2)

FIGURE 15: STATEMENT “SPORTS” (GROUP 2, NON-OWNERS)

“YOU CAN’T WEAR A HEARING AID WHEN YOU

ARE EXERCISING.”

66.2%“Thanks to my

hearing aid, I can finally

truly appreciate nature in full.” 54.9%

“Thanks to my hearingaid, I can (once again) do what I like in my

free time.”

27.6%“Not being able to

hear the sounds of nature can be

very stressful in daily life.”*

n (HI) = 915 Percent top 2 boxes (agree/strongly agree)

*n (no HI) = 1,207 Percent top 2 boxes (agree/strongly agree)



84% “Thanks to my hearing aid, I can travel in whatever way I like.” 915 respondents with hearing aid, percentage of top 3 boxes



TRAVEL AND EVERYDAY MOBILITYA STUDY BY HEAR THE WORLD

Whether we like to travel, discover foreign countries,

languages and cultures, or whether we view leaving our

familiar surroundings as a stressful experience, is no doubt

largely down to our individual own personality. What is

certain is that hearing loss can make travelling more

complicated.

It’s true that few of the respondents without hearing aidsfeel constrained by their hearing loss when travelling – but only if their hearing loss is very mild. More severe hearing impairments can, if they remain untreated, cloudone’s enjoyment of travel considerably. This is shown by a comparison of respondents with and without hearingaids, with moderate to severe hearing loss respectively.The differences start as early as the planning of the trip:61% of respondents with a hearing aid state that they areable to plan their travels with complete flexibility.Respondents without a hearing aid, on the other hand,have to take their hearing loss into account more oftenwhen planning the trip: only 53% feel they are completelyflexible here. And on the trip itself, there is more enjoy-ment with a hear ing aid: of the hearing aid wearers, 69%state that they are able to enjoy their travels with all their

senses, whereas the figure is only 57% for respondentswithout a hearing aid. A similar picture emerges for theexperiences gained during the trip. 71% of hearing aidusers report mainly positive experiences when travelling,but only 62% of those who do not yet wear a hearing aiddo so. Apart from the correction of hearing loss, travellingwith a hearing aid often also has practical benefits, whichthose who travel a great deal appreciate.

Tanja Buelter, who travels a lot for her work as a journalist,says: “What I did not know for a long time is that hearingaids are an enormous advantage when travelling. When Iset the device to flight mode, it is very relaxing. All thebackground noises in the plane, such as air conditioningetc., are almost completely screened out.”

Hearing aids offer benefits not just for travel, but also interms of everyday mobility. Of the owners in the survey,79% confirmed that thanks to their hearing aid, they canget their bearings even in unfamiliar surroundings (top 3boxes). Just as many, 79%, say that finding their wayaround in traffic does not present a challenge to themsince they have been able to rely on their hearing aid (bottom 2 boxes).

“What I did not know for a long time is that hearing aids are an enormous advantagewhen travelling. When I set the device to flight mode, it is very relaxing. All the background noises in the plane, such as air conditioning etc., are almost completely screened out.”

Tanja Buelter, journalist and TV presenter (Germany)



Asked about their physical fitness, 45% of hear ing aidowners and 44% of non-owners say that: “I am as physi -cally fit as my friends and acquaintances.” By com pari son,43% of respondents in the control group agree with thisstatement (top 2 boxes in each case). It appears that hearing loss has no influence on health and physical fitness.Or does it? If we look just at those respondents whose hear -ing loss is more than “mild”, clear differences suddenlyemerge. In the group of hearing aid users, there are still44% who feel just as fit as their friends and acquaintances.However, in the group of those who have not yet done anything about their hearing loss, the figure is only 34%.

Wearing or not wearing a hearing aid affects not only physical fitness, but also other aspects of wellbeing. The“Hearing is Living” study shows that those respondents(moderate to severe hearing loss) who do not wear a hearing aid feel sad or depressed much more frequentlythan the equivalent group of hearing aid owners; they are more likely to feel insecure or angry for no reason,have more often lost interest in areas of their lives thatused to be important to them, feel more isolated and frustrated, and above all they suffer more frequently from insomnia (see Figure 16). The symptoms mentioned

here are generally regarded as possible first indicators ofdepressive disorders.

Dr. Annette Menzel, a doctor specializing in psychiatry,psychotherapy, neurology and psychoanalysis in Kassel(Germany), had these comments on the results: “The relatively high agreement levels for individual aspects of depression in people with hearing loss but without ahear ing aid do not surprise me. One can clearly see thatpeople who do not have a higher-grade hearing loss corrected are more likely to suffer depressive symptoms.”A possible consequence of the faulty communication thatarises through the hearing disorder, Dr. Menzel explains, is isolation of the affected person. People with hearing loss lack the usual opportunities for human contact – theconsequences of this isolation can be the development ofdepression and increased anxiety, but also increasingmistrust of others. It is obvious that a hearing aid canquickly provide relief here. In connection with the slightdifferences in the tendency to depression between the control group and the hearing aid users, the expert pointsout: “Hearing loss does not by any means automaticallylead to depression – it is much more a matter of how onedeals with it.”

69% “I believe that my hearing aid has had a

positive effect on my general state of health.”915 respondents with hearing aids, percentage of the top 3 boxes

“When we read we don’t see every letter of every word in every sentence, but the braintakes what it wants to and relies on its ability to make sense of the sentence. Withsound, the same thing occurs in someone who is partially hearing: part of the sound isheard and the brain interprets the rest. With sound however, it takes more effort and istherefore exhausting.”

Robert Beiny, Audiologist (UK)


14.6%4.7%

20.9%10.7%

n (HI-ms) = 695 / n (no HI-ms) = 282 Percent top 2 boxes (agree/strongly agree)

FIGURE 16: FIRST SIGNS OF DEPRESSION

I often feel sad or depressed

I often feel insecure or anxious

I am often very angry for no reason

I have lost interest in areas of my life which used to be important to me

I often feel isolated, as if I were shut off from the world

I often feel frustrated

I frequently suffer from insomnia

21.915.2

13.4

7.4

13.0

12.0

15.4

24.1

21.0

12.2

17.5

16.7

19.4

31.0


HEALTH AND WELLBEINGA STUDY BY HEAR THE WORLD

Another area within health and wellbeing is “concentrationand relaxation”. Here the study clearly shows that hearingaid owners have an easier time with both of these aspectsthan non-users do. They can concentrate better, and areless likely to lose the thread when telling a story (seeFigure 17). And the respondents with hearing aids alsoseem better at relaxation. 59% of them state that they aregood at relaxing, while for non-users the figure is only 49%(moderate to severe hearing loss in each case).

Dr. Inge Richter, consultant in the department for hearingdamage in the Klinikum am Europakanal in Erlangen(Germany), comments: “Especially when the hearing lossoccurs for the first time when the person is already anadult, communication problems tend to be glossed overand concealed. But this becomes increasingly difficult withincreasing hearing loss. The stress associated with this canlead to a growing impairment of one’s quality of life.” Inher everyday clinical practice, Dr. Richter often finds thatpatients who can no longer compensate their hearing lossadequately complain of diverse physical and mental prob -lems as an expression of the situation of permanent stress.Dr. Richter goes on to explain that treatment with a hearing

aid enables the restoration of an acoustic link with theworld around us, and contributes to an improvement inthe communication situation. “Speech is heard more clearly,and one no longer needs to concentrate so hard all the time.Hearing aid users can thus relax better, experience lessstress, and regain their quality of life.”

Despite all the relaxation, boredom is not a problem forthe hearing aid users who were surveyed. Just under threequarters of the wearers (74%) agree with the statement: “I like to keep myself occupied in my free time – I’m neverbored”, which is just as many as in the control group (73%).In the group of those who do not yet have a hearing aid,only 61% agree with this statement (top 2 boxes, moderate/severe hearing loss).

If one takes all these results together, it is not surprising at all that seven out of ten respondents believe that theirhearing aid has had a positive effect on their health.

HI owners, moderate/severe hearing loss

HI non-owners, moderate/severe hearing loss

HI-ms (n = 695) no HI-ms (n = 282)

“I LOSE TRACK WHEN TELLING A STORY.“

“I FIND IT DIFFICULT TO LISTEN AND CONCENTRATEDURING CONVERSATIONS.“

Top 2 boxes (often/very often)

Top 2 boxes (often/very often)

FIGURE 17: CONCENTRATION



CONCLUSIONA STUDY BY HEAR THE WORLD

With its large number of participants and its comprehensive study design“Hearing is Living” provides many fascinating insights. Not only the overallresults, but also the international comparison between responses is interesting, as there are distinct differences between the different countries.When consolidating the numerous results on a higher level we can distinguish three important findings:

Firstly, hearing influences so many areas of our everyday life that improvedhearing has one benefit above all others: enhanced quality of life. Betterhearing means better communication – in our relationships with our partners,as well as toward friends and family. Good hearing is not merely of benefitto yourself: its positive effects are also directly measurable among family,relatives and partners – this is the first significant insight gained from this study.



The second important insight of the study is that better hearing enables us to experience life in a more active, healthier way, and with fewer restrictions. Stress is reduced, or may be avoided in the first place, concentration is improved, and relaxation is easier.

In this way, good hearing also contributes to enhanced personal wellbeingand general health.

And thirdly, looking at the way people perceive the hearing capability ofothers, the study shows very clearly that wearing a hearing aid does nothave any negative effect on attractiveness. On the contrary: not only relatives and partners, but also the unaffected people in the control group have a very open and positive attitude to the subject of “hearing loss and hearing aids”. That is the final, and very welcome, insight to come out of the “Hearing is Living” research study.


Explanatory notes about hearing loss

Untreated hearing loss Hearing lossthat is not being treated, i.e. no hearingaid, implant, etc.

Mild hearing loss Soft noises are notheard. Understanding speech is difficultin a loud environment

Moderate hearing loss Soft and mod -erately loud noises are not heard.Understanding speech becomes verydifficult if background noise is present

Severe hearing loss Conversationshave to be conducted loudly. Groupconversations are possible only with alot of effort

Explanatory notes about the

survey groups

view Figure 2, page 7

Explanatory notes about the statistics

Weighting Measure used to adjust the structure of the sample to that ofthe population to be investigated in thestatistical data analysis. In this study,Groups 1, 2 and 4 were weighted withrespect to the factors of “age” and “gen -der” to match the populations in thecountries concerned. In addition, theinterrelationships between the indivi-dual countries were weighted for eachgroup so that all the countries studiedwere entered with the same weightinto the total values for each group

HI Hearing instrument

Internet population That part of thetotal population of a country that isaccessible via the Internet (e.g. via PC,laptop, smartphone or any other Inter -net-compatible terminal)

mild/ms Describes the degree of hear -ing loss as assessed by the respondenthim/herself: mild or moderate /severe

n Number of people who answered therelevant question

n (HI) Number of respondents inGroup 1 “HI owners”

n (no HI) Number of respondents inGroup 2 “HI non-owners”

n (relatives) Number of respondents in Group 3 “Relatives”

n (control) Number of respondents inthe “control group” (Group 4)

n (HI-ms) Number of respondents withhearing instrument and moderate tosevere hearing loss. This is a sub-group of Group 1 – only those hearing-aid owners suffering from moderateor severe hearing loss are considered

n (no HI-ms) Number of respondentsaffected by moderate or severe hear ingloss but who do not own a hearing aid.This is a sub-group of Group 2 – onlythose people who do not own a hearingaid and are suffering from moderate orsevere hearing loss are considered

Top boxes Combination of severalagreement levels on a scale to formone aggregated agreement level. Forexample, in the five-step scale used inthe study (strongly disagree, disagree,neither agree nor disagree, agree,strongly agree) the two highest cat -egories of agreement, – i.e. “agree”and “strongly agree” – are combined toform the statement “(strongly) agree”(= top two boxes)

Bottom boxes Similarly, with the bottom boxes, several disagreementlevels are combined to form oneaggregated disagreement level. Forexample, in the five-step scale used in the study, the percentages for thecategories “disagree” and “stronglydisagree” can be combined to form an aggregated level of disagreement:“(strongly) disagree” (= bottom twoboxes)

Study design and survey:

zehnvier research & strategy,

Zurich, Switzerland

www.zehnvier.ch

Project management:

Olivier Richard, Elena Torresani

(Hear the World)

Dr. Kerstin Bolliger, Felix Steinhauer

(zehnvier research & strategy)

Text:

Dr. Kerstin Bolliger,

Prof. Dr. Clemens Koob

(zehnvier research & strategy)

Art Direction:

Antonia Henschel,

Sign Kommunikation GmbH,

Frankfurt am Main, Germany

www.sign.de

Publisher:

Hear the World,

an initiative by Phonak

Copyright:

The use or distribution of the content

of this study is only permitted when

the source is accurately referenced.

A sample of the intended use must

be provided.

Date of publication:

January 2012

Contact:

Phonak AG, Corporate Marketing,

Laubisruetistrasse 28, CH 8712 Staefa


[email protected]


GLOSSARYA STUDY BY HEAR THE WORLD


HEARING IS LIVING

A STUDY BY HEAR THE WORLDHear the World is a global initiative, launched in 2006, byleading hearing instrument manufacturer Phonak createdto raise awareness about the importance of hearing. Theinitiative calls attention to the social and emotional impactof hearing loss and addresses prevention of and solutionsto a problem that affects more than 16% of the world’spopulation. Bryan Adams, Annie Lennox, Lenny Kravitz,Plácido Domingo and other renowned personalities support the Hear the World Initiative as ambassadors. Inthe context of the Hear the World Initiative, Phonak hasestablished the non-profit Hear the World Foundation toimprove the quality of life of people with hearing lossthrough financial and technical assistance. The foundationis committed to the prevention of hearing loss as well asthe support of people with hearing loss and their families.

Hear the World on the internet:


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