2026 Early Hearing Detection & Intervention Conference
March 15-17, 2026 • Jacksonville, FL
| The Follow-up Gap: Racial Disproportionality and Social Determinants of Health in New Jersey’s Hearing Detection and Intervention Program
The Follow-up Gap: Racial Disproportionality and Social Determinants of Health in New Jersey’s Hearing Detection and Intervention Program
Objectives: The purpose of this study was to assess how maternal race/ethnicity and social determinants of health (SDOH) influence loss to follow-up (LTF) in New Jersey’s Early Hearing Detection and Intervention (EHDI) program. Methods: We examined all infants born in New Jersey between June 2015 and June 2017 who were referred for additional hearing healthcare after hospital discharge. The analytic sample included 4,141 infants, of whom 10.7% received no follow-up care after referral. Bivariate analyses examined relationships among race/ethnicity, family-level SDOH, and neighborhood context, including vulnerability and structural racism. Stepwise multi-level logistic regression accounted for county-level clustering in infant delivery and hearing healthcare. Results: Overall, nearly all predictors were significantly related to LTF in bivariate analyses, except WIC participation. Multilevel models revealed persistent racial disparities: infants of Black mothers consistently showed 45–89% higher odds of being LTF than infants of White mothers, even after adjusting for SDOH, while infants of Hispanic mothers had 33–46% lower odds of being LTF. Protective family-level factors emerged: each additional year of maternal age reduced the odds of LTF by 4–5%, and infants of college-educated mothers had 32–41% lower odds compared with infants whose mothers had less formal education. Although nonsignificant in unadjusted analyses, WIC participation became protective in adjusted models, lowering the odds of LTF by approximately 39–40%. County-level clustering accounted for about 12% of the variance in LTF, underscoring the contribution of place-based factors. Conclusion: This study sought to clarify how maternal race and social determinants of health (SDOH)—including both family-level and community-level influences—contribute to loss to follow-up (LTF) between newborn hearing screening and rescreening within New Jersey’s EHDI system. These findings highlight the importance of addressing both family- and community-level SDOH to improve equity in EHDI follow-up outcomes.
- Define systemic barriers and protective factors that affect equitable access to EHDI follow-up care.
- Identify the relationships among race/ethnicity, family-level and community-level social determinants of health (SDOH), and loss to follow-up (LTF) within New Jersey’s EHDI program.
- Analyze how maternal factors—such as age, education, and WIC enrollment—influence the odds of LTF, and explain why some of these factors act as protective influences.
Presentation:
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Handouts:
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Transcripts:
CART transcripts are NOT YET available, but will be posted shortly after the conference
Presenters/Authors
Wendy Zeitlin
(Co-Author), Montclair State University, zeitlinw@montclair.edu;
Dr. Wendy Zeitlin teaches classes in research methods, diversity and oppression, contemporary social issues in child advocacy, and child abuse and neglect. She served as an evaluator on the New York State Social Work Education Consortium from 2007 to 2015 and the Child Welfare Workforce Initiative, funded through the U.S. Children’s Bureau from 2008 to 2015. She continues her child welfare workforce studies in conjunction with the National Child Welfare Workforce Institute (NCWWI). Dr. Zeitlin has authored and co-authored several research articles regarding workforce issues in child welfare and evidence-based practice and has co-authored A Toolkit for Modifying Evidence-Based Practices to Increase Cultural Competence with funding from The Nathan Kline Institute and New York State's Research Foundation for Mental Hygiene. Dr. Zeitlin's research focuses on organizational research, child well-being, cultural competence, and research methods.
ASHA DISCLOSURE:
Financial -
Nonfinancial -
AAA DISCLOSURE:
Financial -
Nonfinancial -
Maryrose McInerney
(Primary Presenter), Montclair State University, mcinerneym@montclair.edu;
Dr. Maryrose McInerney has been practicing audiology in New Jersey since 1981. Dr. Maryrose McInerney is an associate professor at Montclair State University.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exists.
Nonfinancial -
No relevant nonfinancial relationship exists.
AAA DISCLOSURE:
Financial -
No relevant financial relationship exists.
Nonfinancial -
No relevant nonfinancial relationship exists.