B4 School Check hearing screening and middle ear disease: a five-year analysis of prevalence and inequity.

AIM: The B4 School Check includes hearing screening of four-year-old children in Aotearoa New Zealand. This study describes the prevalence and distribution of hearing loss, likely due to otitis media with effusion (OME), to determine if there is inequity in access to screening and primary healthcare, and to inform programme design and delivery.

METHOD: Hearing data over a five-year period were linked with demographic data and interrogated using regression analyses for differences in disease burden, access to screening and to primary healthcare.

RESULTS

Māori and Pacific children and those living with higher deprivation were less likely to be screened. When screened these children had higher rates of disease, were less likely to be referred immediately and had poorer access to primary healthcare to enable appropriate management.

CONCLUSION

The current delivery of hearing screening is inequitable, missing those that need it most and exacerbating an uneven distribution of disease burden. A redeveloped programme to enable identification and screening of all eligible children, differential delivery according to need and a more holistic provision of care is required. This includes support for speech and language concerns, ear health promotion and linkage with primary care and healthy housing programmes.