An inaugural nationwide survey of hearing loss has revealed that about 40% of Australians aged 50 and over have some form of bilateral hearing impairment, but alarmingly, one-third of people in this age group with significant hearing loss don’t use hearing aids.
The Australian Eye & Ear Health Survey provides the first nationwide data on the prevalence of hearing impairment in non-Indigenous and Indigenous Australians.
Report authors said the finding that only 69% of people with moderate or worse bilateral hearing impairment had used a hearing aid “highlights a major concern about unaddressed hearing loss in the older Australian population”.
Mr Mark Butler, Minister for Health and Ageing, Disability and the NDIS, launched the report of eye and ear health, vision and hearing impairment at Parliament House on World Sight Day, 9 October 2025.
It is the second National Eye Health Survey (NEHS) but this time ear health was added, providing the most comprehensive study of its kind, and a contemporary snapshot of the nation’s eye and ear health.
One the report’s authors, Professor Bamini Gopinath, Cochlear Chair in Hearing and Health at Macquarie University Hearing said: “The release of the Australian Eye & Ear Health Survey report ensures that we now have the data we need to plan hearing services, target prevention, and ensure equitable access to hearing care for all Australians.”
The report revealed that, after age standardisation, about 40% of Australians aged 50+ years have some form of bilateral hearing impairment but most of this is mild hearing impairment.
Considerable unmet need
About one in seven (or 14%) aged 50+ have moderate or worse bilateral hearing impairment, a level likely to reflect frequent hearing disability.
Hearing aid usage was similar among Indigenous and non-Indigenous Australians, but, concerningly, only about two-thirds of those with moderate or worse bilateral hearing impairment reported using hearing aids.
“Despite frequent hearing impairment, the uptake of hearing devices remains relatively low, including by many who were clinically eligible for them,” the report said.
“Only 69% of persons with moderate or worse bilateral hearing impairment had used a hearing aid. This suggests a potential gap between clinical need and device use, even among those who met the Australian criteria for subsidised hearing aid eligibility as outlined in the Australian Government Hearing Services Program (64% of all participants).
“This likely gap between need and use highlights a major concern about unaddressed hearing loss in the older Australian population.”
Hearing impairment appeared to occur at an earlier age and was more prevalent in the ‘younger’ group of Indigenous Australians aged 50 years or older compared to non-Indigenous Australians. Indigenous people were also more likely to report having hearing problems for longer and were less likely to consult a hearing professional.
“These findings suggest there may be considerable unmet need in addressing hearing impairment in older Australians generally, and particularly among the ‘younger’ group of Indigenous Australians aged 50 years or older,” researchers said.
More common and severe in males
Hearing impairment was more frequent and severe in males than females in both groups. Prevalence of any bilateral hearing impairment was 58.5% for Indigenous males and 39.7% for females, compared with 55.9% for non-Indigenous males and 46.9% for females.
Professor Paul Mitchell, the principal investigator, from Westmead Institute for Medical Research, said that as well as building on vision impairment data generated by the 2015-2016 NEHS, the new survey added advanced ophthalmic imaging to define eye conditions in greater detail, and added assessment of hearing loss, ‘as the first nationwide survey of this key disability’.
Over the past three years, 4,519 Australians aged 50 years and older, living at 30 randomly selected sites across six states and two territories, answered questions and had comprehensive eye and ear examinations. Ear examinations included video otoscopy, pure tone audiometry and tympanometry. More than 600 Aboriginal and Torres Strait Islanders participated.
The report said data on the prevalence of hearing loss in Australia remained limited, with only the Blue Mountains Hearing Study (BMHS) having reported these data. The BMHS from 1997-2000, recruited 2,956 non-Indigenous adults aged 55 years and over, and reported prevalence rates of bilateral hearing impairment of 39.1%, 13.4% and 2.2% for mild, moderate and severe to profound bilateral hearing impairment, respectively.
The Hearing Health Sector Alliance (HHSA)’s Roadmap for Hearing Health had recently highlighted the need for action to identify and prevent hearing loss and close the gap for Indigenous ear and hearing health, the report said. Previous eye studies and the HHSA roadmap led to the survey focusing on evaluating eye and ear health.
During the survey, 18,145 homes were door-knocked. The hearing survey recruited 3,573 of 4,519 eye study participants, of whom 461 (12.9%) were Indigenous and 3,112 (87.1%) were non-Indigenous.
Results showed encouraging signs of progress with reductions in rates of vision impairment across Indigenous and non-Indigenous Australians since 2016, driven by improvements in cataract surgery and refractive error correction.
But inequities remained including vision impairment rates among Aboriginal and Torres Strait Islander people still being almost three times higher than non-Indigenous Australians.
Targeted action required
Ms Carly Iles, Vision 2020 Australia CEO, said findings underscored the need for continued national leadership and targeted action.
“This survey provides the evidence base we need to ensure no one in Australia is left behind when it comes to seeing and hearing well,” she said. “It’s an important reminder that progress is possible, but only if we stay focused on access, prevention and early intervention.”
The crude prevalence of any bilateral hearing impairment (hearing impairment >25 dB HL in the better ear, over a 4-frequency average) was 50.6% and was similar among Indigenous (49%) and non-Indigenous (50.8%) Australians.
The age-standardised prevalence was similar in both groups, decreasing to 42.8% for Indigenous participants and 39.4% for non-Indigenous.
Rates of mild, moderate and severe hearing loss also did not differ statistically between Indigenous and non-Indigenous people. While 28.5% of Indigenous participants had mild bilateral hearing impairment, 11.2% had moderate and 3% severe or profound bilateral hearing impairment. Among non-Indigenous participants, 26.3% had mild, 11.1% moderate, and 2.1% severe bilateral hearing impairment.
Age-standardised prevalence of moderate or worse bilateral hearing impairment was 14.2% overall in people aged 50 years or older, and only marginally greater among Indigenous participants (14.3%) than non-Indigenous participants (13.2%).
Increased with age
Prevalence of bilateral hearing impairment was highly age-dependent, with highest rates in older Australians. Among Indigenous Australians it rose from 31.7% in those aged 50-59 years to 45.6% (60-69 years), 65.3% (70-79 years) and 83.3% (80+ years).
For non-Indigenous people, it also increased exponentially from 15.6% in those aged 50-59 years, to 35.3% (60-69 years), 58.5% (70-79 years) and 84.0% (80+ years).
Prevalence was higher by 12% to 100% in Indigenous participants compared with non-Indigenous participants in every age group except those aged 80+ years, where it was similar.
Combined moderate, severe and profound hearing impairment among ‘younger’ Indigenous participants was three times higher than in similarly aged non-Indigenous participants (9.4% v 3.2% among those aged 50-59 years).
This difference narrowed to two times higher in those in their 60s (14.3% v 6.9%) and continued to narrow to 20% higher in those in their 70s (22.4% v 18.5%). It was similar in the oldest age group (47.6% v 47.8%), those aged 80+.
Cochlear implants were used by 0.2% of participants.
Dual sensory impairment
Dual sensory impairment (DSI) – vision and hearing impairment – had an overall age-standardised prevalence of 2.5% for any hearing impairment, and 1.3% for moderate or worse hearing impairment.
DSI was strongly age-related and was two times higher in Australians aged 50 and over who were Indigenous (5.2%) than those who were non-Indigenous (2.5%).
Diabetes and smoking risk factors
The researchers said factors that disproportionately affected younger Indigenous Australians in the 50+ age group may lead to earlier onset of hearing impairment that persists into older age.
The report identified diabetes and smoking as risk factors for hearing impairment. Remoteness was strongly associated with higher risk of vision impairment but not hearing loss.
Factors associated with a reduced risk for hearing and vision impairments included higher education level and having private health insurance. For hearing, this could represent a proxy for occupations that did not include major noise exposure, researchers said.
The Westmead Institute for Medical Research delivered the survey in collaboration with partner universities and organisations across the sector. The Australian Government funded it, with additional support from the Martin Lee Centre for Innovations in Hearing Health at Macquarie University and Vision 2020 Australia, which championed the call for the follow-up national survey.
Report authors said findings would guide future policy, service delivery and advocacy to further reduce preventable vision loss and hearing impairment across Australia.
The researchers were Macquarie University Cochlear Chair in Hearing and Health, Professor Bamini Gopinath and audiologist Ms Oonagh Macken; Prof Paul Mitchell, Mr Richard Kha, Mr Gerald Liew, Dr Gary Low, Mr George Burlutsky and Clinical Associate Professor Andrew White from the Centre for Vision Research, Westmead Institute for Medical Research; Ms Yasemin Kapucu, Ms Colina Waddell and Ms Alemka Davis from Brien Holden Foundation; and Mr Tim Fricke, Ms Eleanor Yang and Professor Lisa Keay from UNSW School of Optometry and Vision Science. Fricke is also from the Australian College of Optometry.
Read the full report and the summary.
