Associations between hearing difficulty, labor force status, and health burden in young stroke survivors

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Background: Young adults with stroke often experience functional impairments, which may be exacerbated by hearing loss. This study examined associations between employment disruptions and functional, physical, and mental health limitations among young stroke survivors with and without self-reported hearing difficulty. Methods: This analysis used data from the 2020 to 2023 Behavioral Risk Factor Surveillance System (BRFSS) for adults aged 18-49 with self-reported stroke. Outcome measures included functional limitations-including concentration/memory, mobility/walking, dressing/bathing, and completing errands-and the number of days with poor physical, mental, and overall health. Logistic and negative binomial regressions examined the associations between these outcomes, employment status, and hearing difficulty, controlling for sample heterogeneity. Interactions between hearing difficulty and employment status were assessed to examine potential differential effects. Results: Respondents who reported hearing difficulty had significantly greater odds of functional limitations, including difficulty concentrating (OR = 2.60, 95% CI: 1.56-4.35), doing errands independently (OR = 3.71, 95% CI: 2.22-6.21), dressing or bathing (OR = 6.09, 95% CI: 3.30-11.24), and walking or climbing stairs (OR = 3.66, 95% CI: 1.89-7.09). Hearing difficulty was also independently associated with a greater number of poor physical health days (IRR = 1.39, 95% CI: 1.02-1.89) and poor mental health days (IRR = 1.67, 95% CI: 1.30-2.14). Being out of work or out of the labor force was independently associated with poorer functional, physical, and mental health outcomes. Conclusions: These findings underscore the need for integrated post-stroke rehabilitation strategies that address sensory, cognitive, and social dimensions.

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