Hearing impairment, social support, and depressive symptoms among U.S. adults: A test of the stress process paradigm

- Research on the relationship between hearing impairment and depressive symptoms is mixed.
- Hearing impairment is a physical health stressor that can affect mental health outcomes.
- The relationship between hearing impairment and depressive symptoms differs by levels of social support.
- People with hearing impairment with high levels of social support are protected against an increase in depressive symptoms.
- Improvements in social support for people with hearing impairment may protect against negative mental health impacts.

Hearing impairment is a growing physical disability affecting older adults and is an important physical health stressor, but few studies have examined it in relation to mental health outcomes and even fewer have considered the role of social support in buffering this relationship. The current study builds on the stress process framework and uses longitudinal data from three waves of the Health and Retirement Study (2006, 2010, 2014) to examine the relationship between hearing impairment and depressive symptoms among U.S. adults aged 50 and older (n = 6075). The analysis uses fixed-effects models to assess this relationship and examine the extent to which social support mediates (buffers) or moderates (interaction) the association. The results found that worse self-rated hearing was associated with a significant increase in depressive symptoms, even after controlling for sociodemographic factors. Social support did not buffer this relationship. Instead, social support interacted with hearing impairment: low levels of social support were associated with more depressive symptoms but only among people with poor self-rated hearing. Among those with excellent self-rated hearing, low levels of social support did not increase depressive symptoms. Moreover, high levels of social support reduced depressive symptoms for those with poor hearing. These findings suggest that hearing impairment is a chronic stressor in individuals' lives, and that responses to this stressor vary by the availability of social resources.