Jeanette Contreras portrait

Leaders in Congress support safe OTC hearing aid standards

By NCL Director of Health Policy Jeanette Contreras

Mild to moderate hearing loss is a difficult reality that millions of Americans struggle with, which is why the availability of over-the-counter (OTC) hearing aids is exciting for those who are impacted by hearing loss. While making OTC hearing aids more accessible is a promising step for consumers, we at NCL would be remiss if we didn’t underscore our concerns around the Food and Drug Administration’s (FDA) proposed OTC hearing regulations as they currently exist.

In December of last year, NCL was one of hundreds of organizations who submitted a comment to FDA’s public docket on the issue; and last month we submitted a letter voicing our concerns to the FDA that was supported by 29 not-for-profit, public health organizations across the country. These organizations collectively represent the concerns of millions of consumers, patients, and individuals impacted by hearing loss.

We want to reiterate our enthusiasm for OTC hearing aids, but as the gold standard of safety in our country, it is imperative that the FDA make sure these devices are safe for consumers and do not worsen a problem they are intended to mitigate. As written, the draft regulations would allow for a maximum sound output level of 120 dBA – equivalent to the volume of a chainsaw or fire engine siren. This is concerning, as exposure to sounds at 120 dB can be dangerous in as little as nine seconds according to the CDC. This is why NCL, along with other leading consumer and healthcare voices, encourage the FDA to follow the recommendations of hearing care professionals, including the American Academy of Otolaryngology–Head and Neck Surgery that recommend a maximum output of 110 dB and a gain limit of 25 dB. Without a limit on gain, OTC hearing aids users will be able to amplify sounds to dangerous levels, and far beyond what Congress authorized when it said these devices must be limited to adults with moderate hearing loss or less.

The safety parameters we are recommending would in no way compromise the efficacy of OTC hearing aids intended for individuals with perceived mild to moderate hearing loss. In fact, a recent study concluded that commercially-available hearing aids programmed according to parameters typical of those used for individuals with mild to moderate hearing loss yield effective output and gain levels and are within the recommended limits specified by leading hearing care organizations and medical experts.

Importantly, the FDA has already cleared several hearing aids for adults with perceived mild to moderate hearing loss that were found to be safe and highly effective during clinical trials. While these devices were authorized under a different category of hearing aids, these devices limit the maximum output to 115 dB or below and gain to 30 dB or less, lower than the amplification limits currently proposed by the FDA. At the very least, the FDA should incorporate these amplification limits in the final OTC hearing aid regulation.

Finally, as we await finalized guidance from the FDA, we applaud leaders in Congress who are standing behind consumers in supporting safe and effective amplification limits. Last month, Congresswoman Betty McCollum (D-MN) and Congresswoman Rosa DeLauro (D-CT) sent a letter to the FDA echoing their safety concerns. The letter states, “[The proposed rule] hurts consumers and patients in two ways. First, it means individuals suffering from greater levels of hearing loss could put off a needed visit with a licensed hearing professional. Doing so could lead to worsening their existing symptoms, delaying an accurate diagnosis and treatment, and even creating irreparable damage to their hearing. Secondly, it means those with perceived mild-to-moderate hearing loss would be exposed to harmful levels of noise that could result in further damage to their long-term hearing. In order to avoid these concerns, FDA should impose a gain limit of 25 dB and an overall output limit of 110 dB.”

Similar to the countless other experts that have also weighed in, we believe that establishing safe amplification limits would not reduce the efficacy of these devices or limit the advancement of innovative technologies. We thank Congresswomen McCollum and DeLauro for being a voice for consumers and patients on this important issue. To learn more about gain and output and how to protect yourself from hearing loss, check out our infographic.

Breyault and Amazon’s Alyssa Betz discuss policing fake reviews and counterfeits

 

By NCL Staff

 

This week, John Breyault, our Vice President of Public Policy, Telecommunications, and Fraud, sat down with Amazon’s Director of Public Policy, Alyssa Betz. On this episode of NCL’s We Can Do This! podcast, Alyssa and John discussed fake reviews, Amazon’s product liability, and more. This has been the latest collaboration between Amazon and NCL in our partnership towards improving consumer safety and online experiences.  

Fake Reviews 

With users increasingly relying on user reviews to make buying decisions, having access to trustworthy reviews is critical for consumers. Last month, Amazon sued a group of review brokers who were allegedly paying for fake reviews at large scale. In addition to discussing the suit, Betz outlined some of the steps they have taken to ensure that user reviews are trustworthy and accurately reflect consumers’ experiences. 

Counterfeits 

Given the vast number of products sold through nearly two million sellers worldwide, Amazon has an enormous responsibility to ensure consumer safety. Alyssa discussed some of the measures Amazon has taken to reduce criminals’ ability to operate on their platform, including investing over $700 million and employing more than ten thousand people to protect its store from fraud and abuse, including counterfeit products.

To hear the full episode, including John and Alyssa’s conversation about product liability and how to spot those phony Amazon delivery phishing texts, click here. 

If you have received suspicious communications or packages claiming to be from Amazon, you can find Amazon’s support page here. 

Why we need more Black health professionals in the workforce

By NCL Health Policy Associate Milena Berhane

A lack of diversity in the health care workforce has been a persistent issue in the United States, posing significant implications to health equity, particularly for the Black or African American community.

An estimated five percent of physicians identify as Black, despite making up 13 percent of the U.S. population. A recent study utilizing U.S. Census Bureau information found that the proportion of Black physicians in the United States has only increased by four percent in more than a century — from 1900-2018. This study also reported that the percent of Black male physicians has remained relatively stagnant since 1940. Diversity issues also exist in other health care professions, with an estimated 7.8 percent of nurses, 3.8 percent of dentists, and 2.5 percent of physical therapists being Black.

The education, testing, application, and interviewing process required to pursue a career in health care is rigorous and costly. In addition to a four-year degree, candidates are also required to take standardized exams, pay expensive application fees, and pay for travel to interview. Most medical students expect to spend up to $10,000 for the application process. Once accepted to a health professional program, the tremendous monetary and time costs of schooling are immense obstacles for many. Medical school attendees accumulate an average $200,000 of student loans by the time they are finished with their programs.

Due to generations of systemic racism in our country, Black Americans are less resourced — financially and in terms of social capital — than their white counterparts. The rigorous process of applying to and remaining in health professional programs creates a pipeline that excludes disadvantaged students from the ability to pursue careers in clinical care.

The barriers to enter the workforce have further negative impact on communities and health equity. Black patients face a variety of issues that can influence their ability to access medical care, including medical mistrust caused by historical unethical medical mistreatment faced by Black Americans, dismissal of health concerns that Black patients express to health care providers, and others. Time and time again, Black patients have shared their experiences of medical providers ignoring their health concerns, and therefore being undertreated and going undiagnosed for their conditions. In addition, research indicates that Black patients report poorer patient-provider communication and shared decision-making. These issues lead to Black patients receiving lower quality care from medical providers, further worsening health conditions that could be treated.

Racial bias and a lack of culturally competent medical care in the healthcare system has led to poorer health outcomes for Black patients. Black Americans of all ages already face higher rates of hypertension, asthma, diabetes, and other health issues due to systemic racism and how it has affected the environments they live in, the food they have access to, their education prospects, income, etc. These inequities compiled with a culturally incompetent and bias medical system leaves Black Americans with little ability to receive proper medical treatment and improve their health and well-being. Although medical schools are attempting to teach the importance of culturally competent care, it is crucial that Black patients are also able to access healthcare providers that look like them and come from their communities.

Clearly, the current make up of racial diversity of the health care workforce has failed to keep up with the demographic shifts in the United States. Although public health efforts are important in addressing and improving health equity, inequities within the medical system must be addressed simultaneously. The COVID-19 pandemic has only highlighted and exacerbated health inequities. Increasing the amount of Black health professionals across the United States is a critical step in ensuring better health outcomes for Black patients and their overall well-being.

Annual fraud report highlights crypto insecurity

By Eden Iscil, Public Policy Associate

Earlier this month, NCL’s Fraud.org project released its annual Top Ten Scams report. After collecting thousands of consumer complaints, we sorted through the data to share the major trends from the past year. We saw some interesting trends! 

As the pandemic has entered its third calendar year, notable patterns included median dollar losses from fraud reaching a 10-year high and investment-related scams increasing by almost 170 percent, likely due to the rising popularity of cryptocurrency. So, consumers who lose money to scams are losing more of it. And cryptocurrency-related scams are something we all need to start paying attention to. 

These are the top ten scams reported to Fraud.org in 2021: 

  1. Prizes/Sweepstakes/Free Gifts  
  2. Internet: General Merchandise  
  3. Phishing/Spoofing  
  4. Fake Check Scams  
  5. Friendship & Sweetheart Swindles  
  6. Investment: Other (incl. cryptocurrency scams)  
  7. Advance Fee Loans, Credit Arrangers  
  8. Family/Friend Imposter  
  9. Computers: Equipment/Software (incl. tech support scams)  
  10. Scholarships/Grants 

The categories with the highest median losses were fake check scams at $2,000 and investment scams at $1,750. 

Focus: Cryptocurrency driving investment fraud 

Fake check scams have often scored near the top on our annual trend reports, but investment scams jumped several ranks, more than doubling their share of consumer complaints. Given the explosive growth of cryptocurrency usage in 2021, the emerging market likely provided an opening for fraudsters to take advantage of still-developing regulations and a lack of consumer knowledge about these new forms of investing.  

Fraud.org’s data appears to take the same shape as trends from the Federal Trade Commission (FTC), which had reported a ten-fold increase in cryptocurrency fraud. The FTC’s data spotlight on cryptocurrency scams also included a median loss of $1,900, a figure further demonstrating the heightened risk that consumers face within this sphere. Unfortunately, consumer protections in cryptocurrency usage are largely a patchwork of state-by-state rules, with some trading regulated by the Securities and Exchange Commission (SEC). 

Notably, Bitcoin and Ethereum (the two most popular cryptocurrencies) have so far been exempt from the SEC’s strictest oversight requirements, as it is considered a commodity rather than a security. The lack of comprehensive, nationwide protections coupled with the fact that these coins exist to be anonymous, instant, and irreversible creates an unsafe environment for consumers—especially ones who may be entering this space for the first time.  

Although media buzz has generated a lot of interest in crypto, with reports often centered on the potential for eye-popping returns, these articles do a disservice to readers if they don’t include the risks involved. Market volatility, a lack of consumer protections, and environmental damage only scratch the surface when it comes to hazards related to virtual currencies. These liabilities can be minimized by sticking with traditional forms of payment and investment—pending comprehensive regulation of digital coins. 

The full Top Ten Scams Report for 2021 can be found here. Additionally, Fraud.org’s February Fraud Alert includes great tips to help consumers better protect themselves against 2021’s top scams. 

COVID-19 increasing health concerns about obesity

COVID-19 increasing health concerns about obesity
By Nailah John, Program Associate

The pandemic has brought many countries to a standstill, restricting movement, necessitating social distancing, and impeding economic activities across a broad spectrum of nonessential occupations. It’s also resulted in many people changing their habits, including changes in food consumption, physical activity, and an increase in people working from home, which may exacerbate current levels of obesity.

Obesity is a major concern here in the United States and worldwide. The World Health Organization defines obesity as “abnormal or excessive fat accumulation that may impair health.” In 2016, the World Health Organization released data that showed 650 million adults were obese, and in 2019, an estimated 38.2 million children under the age of 5 were overweight and obese. In the United States, the Center for Disease Control and Prevention indicates that, in 2019, the obesity rate surpassed the 40 percent mark and reached 42.4 percent.

Since the pandemic began, there have been dozens of studies reported that many patients who become sick with COVID-19 are obese. In an article in the journal Obesity Reviews, an international team of researchers compiled data from scores of peer-reviewed papers capturing 399,000 patients. The findings indicated that individuals with obesity suffer from metabolic dysfunction and low-grade inflammation, which are considerable factors in the manifestation of severe lung diseases. The primary cause of COVID-19 mortality is susceptibility to acute respiratory distress syndrome (ARDS) which is more likely in obese individuals. The review goes on further to state that “being an individual with obesity independently increases the risk of influenza morbidity and mortality, most likely through impairments in innate and adaptive immune responses. Potentially the vaccines developed to address COVID-19 will be less effective for individuals with obesity due to a weakened immune response.”

The Wiley Public Health Emergency Collection found that obesity increases vulnerability to infections and is a risk factor to COVID-19-related mortality. Body mass index (BMI) was significantly higher in patients with a severe form of Covid-19 infections. Being obese increases the odds of COVID-19 patients being hospitalized. The Wiley Public Health Emergency Collection highlighted that COVID-19 patients with obesity were hospitalized more than those without obesity. According to a report that looked at 5,700 COVID-19 patients with obesity in New York City, whereas 22 percent of the population is obese, they make up 41.7 percent of hospitalized patients.

Prevalence of obesity in the United States is increasing yearly, and there is a dire need for this health issue to be curbed. It will take efforts at the federal, state, and local level. Therefore, it is paramount that each individual engages in healthy eating habits, eats the right portion sizes, engages in physical activity, and encourages others.