HKS MPA 2023 Janice Lintz argues that cities must incorporate hearing access into plans for infrastructure upgrades (Pictured: Austin, Texas)

Rethinking Cities for People with Hearing Loss

We need to ensure that cities upgrade hearing access as part of the Infrastructure Investment and Jobs Act. The Act, which was approved by the Senate, will provide American cities with $1 trillion to rebuild airports, ferries, terminals, public transit, and rail, to name a few of the categories under President Biden’s “Build Back Better” program. Upgrading hearing access needs to be part of upgrading America. Therefore, we need to mandate that cities incorporate hearing access into their plans.

According to the National Institutes of Health, “One in eight people in the United States (13 percent, or 30 million) aged 12 years or older has hearing loss in both ears, based on standard hearing examinations, [and a]bout 28.8 million U.S. adults could benefit from using hearing aids.”[1] Yet hearing access across America is sporadic and occurs primarily based on successful advocacy.

Part of the reason is that decision-makers have antiquated ideas about what hearing access is needed. Cities need to update their perceptions of the 48 million people with hearing loss; otherwise, they may inadvertently add incorrect access. Based on my 19 years of advocacy, most access coordinators use wheelchairs and make decisions about hearing loss without knowing anything about it.

People tend to mistakenly assume that a person with a particular disability understands all disabilities. Another fallacy is that having a particular disability automatically makes someone an expert on that disability. Sadly, many people are uneducated about their own disabilities. Just as I am not an expert about my cell phone by owning it, a person with hearing aids or a cochlear implant is not an expert by using the devices. The knowledge base is not imputed to them when they start wearing the device.

A sign in a train station advising travellers that the public announcement system broadcasts with a hearing induction loop, to allow travellers with a hearing aid to tune into announcements directly with their hearing aid’s receiver. Courtesy Wikimedia commons user avlxyz.
A sign in a train station advising travellers that the public announcement system broadcasts with a hearing induction loop, to allow travellers with a hearing aid to tune into announcements directly with their hearing aid’s receiver. Courtesy Wikimedia commons user avlxyz.
A sign in a train station advising travelers that the public announcement system broadcasts with a hearing induction loop, to allow travelers with a hearing aid to tune into announcements directly with their hearing aid’s receiver.

People with hearing loss who use assistive listening prefer an induction loop assistive listening system that permits them to receive the sound directly in their hearing aid or cochlear implant by switching to the telecoil or T-setting. Unlike infrared and FM assistive listening systems, an induction loop doesn’t require the use of a stigmatizing receiver that has to be borrowed from and returned to the venue and contains a battery that has not always been recharged.

In settings where there are both visual and auditory features, such as a play, people with visual disabilities prefer an FM system, since multiple tracks permit audio descriptions on one channel while assistive listening can be provided on another channel. However, as explained above, people with hearing loss prefer induction loops, and government entities are required to consider the person’s preferred form of access. The appropriate solution is to provide both induction loops and FM systems where both assistive listening and audio description are needed.

Further, most people don’t understand that hearing loss is a spectrum, and the entire range needs access. While assistive listening systems benefit the largest proportion, others have different communication access requirements. Of the 48 million people with some form of hearing loss, “[f]ewer than two million, and likely fewer than one-half million people in the United States use [American Sign Language] ASL.” (According to a 2006 paper produced by Gallaudet Research Institute at Gallaudet University[2] states then the data was outdated and not based on proper studies. According to Gallaudet University, there are no studies since 1974 on the number of people who use American Sign Language. A larger number of people require captioning and CART (communication access realtime translation).

Therefore, a three-prong approach is necessary to achieve effective communication to reach the whole spectrum of people with hearing loss. Cities need to provide:

1) An assistive listening system

2) Captioning and CART

3) Qualified Interpretation/ASL

I provide further details on Effective Communication in my White Paper. The three categories are the equivalent of ramps for people with hearing loss, and omitting one leaves out a part of the hearing loss population.

The US National Park Service, The Government of Ecuador, PANYNJ, and some museums around the country are consistent with this approach.

Cities unfamiliar with hearing access rely on vendors to determine what access to select by using Requests for Proposals (RFP) rather than Requests for Bids (RFB). Cities should decide, not vendors, since vendors sell what is easiest to install and has the highest profit margin. Unfortunately, vendors’ interests don’t necessarily align with what is best for people with hearing loss.

Cities don’t have induction loops in their procurement codes, so they use generic codes based on the United Nations (UN) coding. However, the UN doesn’t have a code for induction loops and needs an upgrade on hearing access. Thus, cities should upgrade their procurement codes to include induction loops.

Hearing access should be part of every project, including adding induction loops for people who are hard of hearing to:

• Rail cars, platforms, and ticket windows

• City council rooms and town hall meetings, so people with hearing loss can participate

• Courtrooms, to allow judges, attorneys, courtroom employees, jurors, and witnesses with hearing loss to participate in legal proceedings

• Library meeting rooms and service desks

• Police stations’ front desks and interrogation rooms

• Schools’ classrooms, libraries, and auditoriums

• All city-owned public sites (health facilities, museums, historic houses, etc.)

Public cable channels should offer closed captioning.

Cities should incorporate induction loops, captioning, CART, and ASL interpreting in their contracts. The City of Los Angeles’ Department on Disability in a letter to Mayor Garcetti recommends that, “all City vendor contracts and agreements contain language requiring accessible communication for programs and facilities, and that public facilities and transportation projects (whether new developments or refurbishing), include Induction Loop Technology (ILT) wherever a public announcement system or other audio system will be used regularly to communicate information to the public.” All cities should follow Los Angeles’ lead and incorporate induction loops in their vendors’ contracts so that America upgrades hearing access as part of its “Build Back Better” program.

About the Author

Janice S. Lintz is an accomplished consultant/advocate across the hearing access, advocacy, and related political spectrum. She is the CEO of Hearing Access & Innovations, which is the leading company dedicated to helping the world’s businesses, cultural and entertainment institutions, government agencies, and mass transit organizations improve their accessibility for people with hearing loss. She will graduate from Harvard’s Kennedy School in 2023.

Research center and think tank at Harvard Kennedy School. Here to talk about democracy, government innovation, and Asia public policy.