Source note: This independent Dispatch explainer cites materials developed by the Centers for Disease Control and Prevention. The original materials are available on CDC’s website at no charge. CDC, HHS and the U.S. Government do not endorse the Dispatch, its owner, or products and services offered by either.
A county hearing-disability percentage is useful only when its definition travels with it. CDC’s PLACES program gives ENT readers geographic context drawn from population estimates. Reading the number responsibly starts with four questions: which hearing measure, which observation year, which estimate type and what uncertainty? A map’s visual precision does not settle those questions.
The hearing measure begins with a survey response. CDC identifies the question as: ‘Are you deaf or do you have serious difficulty hearing?’ The indicator therefore concerns reported deafness or serious hearing difficulty among adults aged 18 and older. It is not a count of people who received an audiometric examination. Clinical diagnosis and treatment eligibility cannot be read from that question alone. CDC also notes that disability survey estimates can differ with survey design and administration.
PLACES uses small-area estimation. Its methodology combines BRFSS survey information with Census population and American Community Survey inputs. A statistical model produces local estimates rather than a new census of hearing status in every county. CDC describes the approach as multilevel regression and poststratification and supplies 95% confidence intervals generated through simulation. The model and its uncertainty are part of the result, not optional background.
This explainer examines the December 2025 PLACES release. CDC’s release-notes page is dated March 16, 2026. Most measures in that release use 2023 BRFSS information, while five named measures use 2022 information. Those carried-over measures do not include hearing disability, whose survey observation year for this release is 2023. A current webpage or download should not be labeled a measurement of hearing in October 2026. Record the observation year separately from the release label and the day an analysis was prepared.
The definition page lists crude and age-adjusted prevalence. An account using the data should identify which type it reports and preserve that choice across comparisons. It should carry the confidence limits alongside any percentage and explain the modeling method. This methods brief does not calculate county differences, test statistical significance or rank places. A separate analysis would need to establish its comparison design before describing a difference as meaningful.
Coverage also has limits. CDC says Kentucky and Pennsylvania estimates are unavailable for measures based on 2023 BRFSS. That absence cannot be turned into zero hearing disability. The five carried-over 2022 measures available for those states do not fill the hearing-data gap. State coverage, missing rows and the underlying year belong beside any map or table built from this release.
For an ENT practice, the disciplined use is population context with its methods visible. A prevalence estimate alone supplies no verified appointment forecast, referral volume, surgical candidacy or account of local service capacity. Those are different questions requiring different evidence. A useful hearing map makes its definition, year, estimate type, interval and coverage easy to find—and leaves unanswered questions unanswered.
Go to the source.
CDC PLACES methodology ↗CDC PLACES disability measure definitions ↗CDC PLACES current release notes ↗CDC use of agency materials ↗This methods explainer describes historical model-based survey estimates. It does not diagnose a condition, forecast appointments or establish treatment eligibility.
