Hearing health where audiologists are scarce: a pilot hearing screening of students and school staff in rural Mississippi

Hearing loss and unsafe listening behaviors disproportionately affect underserved communities, yet community-based screening data from rural school communities in the Deep South are nearly absent from the literature. We conducted a cross-sectional hearing screening of students and school staff at six schools in Simpson County, Mississippi, enrolling 109 participants (57 under 18 years and 52 aged 18 years or older; overall median age 17 years). Pure-tone air-conduction thresholds from 250 to 8,000 Hz were measured with a validated tablet-based audiometer, and participants completed a 19-item survey covering recreational noise exposure, tinnitus, hearing protection, and prior testing. Better-ear pure-tone average thresholds were largely within normal limits (overall mean 7.2 decibels hearing level; only 7% met the 20 decibel threshold for functional hearing loss). In contrast, self-reported behavioral and symptom burden was high: 69% of headphone users reported high-volume listening, 41% reported tinnitus, 81% used no hearing protection, and 22% had never had a hearing test. None of these measures differed significantly between the younger and older groups, although the sample was small and predominantly adolescent. Among the 99 participants with normal audiograms, 40% still reported tinnitus and 42% reported perceived hearing decline. These preliminary findings suggest that, in this community, audiometry alone would substantially understate hearing-health needs that a brief symptom-and-behavior survey makes visible. Pairing low-cost, booth-free audiometry with a short questionnaire and same-visit results offers a low-barrier screening model suited to structurally underserved populations.