Although the World Health Organization („WHO“) has identified hearing loss as a global desease and the second most frequent disability after vision impairment, there are significant regional and national differences. In countries where economical resources are scarce and health care is not easily accessible, the rate of persons with hearing loss is high and the use of hearing technologies is low. Yet economical wealth and availability of health care cannot be the only factors since even among western democratic countries with national health care systems, the rate of hearing aid use differ. In Europe, Denmark has the highest compliance rate with 40%, whereas in Germany and Switzerland it is less than 20% and in Finland less than 15%. Similar to Denmark, the compliance rate in Australia is almost 40%.

We are also interested in the cultural and linguistic differences surrounding communication with hearing loss and hearing aids. One obvious area related to hearing loss where languages differ is their sound system. Even the sound inventories of such related languages as Danish and German could be relevant because Danish has 25 vowel phonemes compared to 14 in German, and Danish features 5 levels of tongue height in contrast to 4 in German. The differences in sound inventory of individual languages is further related to hearing loss in regard to the role of those sounds that are lost first (high pitched soft sounds like ‘s’ and ‘f’) because these are used differently in languages. While in Finnish only one s-sound is lost, in German five s-sounds are lost [s, z, ?, ts, t?]. Such linguistic differences may have an impact on sound discrimination and morpheme recognition in testing hearing loss and in miscommunication in general.

A society’s attitude towards disability and illness is reflected in how it is treated in the health care system. While in Denmark and Australia, the western countries with the highest usage rate of hearing aids (40%) , a hearing pedagogue or counselor is an integrated part of the routine path through the health care system, this is not the case for Germany and Switzerland, where hearing aid compliance is around 15%. How culture also influences communication in everyday life and at the workplace is a focal research objective in the Hearing Aids Communication network.