A commitment to improving diversity, equity, inclusion, and accessibility (DEIA) is critical for better science and a better society. A concrete example of this for deaf people is the use of sign language in academic and clinical environments. In a Brazilian study on deaf people's experience with primary care, most participants reported insecurity about medical appointments. Those who best understood their diagnosis and treatment were bilingual individuals and those who used oral communication. 1 But what role could publishers, medical societies, and scientific organizations play in achieving these goals? In this editorial, we will address access to health services among deaf people and its impact on health outcomes.
Hearing loss and individualitiesStudies have shed light on the physiology of the auditory system, which is fundamental to understanding the diversity found in the deaf community. A study by Silva 2 discusses the 3 types of auditory load described in Silman & Silverman's classification system: 3 conductive, neurosensory, and mixed.The first type is caused by inflammatory processes, excess cerumen in the external auditory canal, changes in the articulation of the auditory ossicles and tympanic membrane, malformations of the external ear, etc. Hearing function can be completely restored in most of these cases. The second type is caused by degeneration due to the natural aging process, industrial or environmental noise exposure, drugs, stress, metabolic alterations, chronic diseases, head trauma, and diseases of the inner ear, such as Ménière's disease or auditory neuropathy, etc. Hearing loss of this type is considered irreversible, and the remaining sensory cells are stimulated through external amplifiers. The third category, defined as mixed hearing loss, occurs due to changes in the auditory system that can simultaneously affect the outer, middle, and inner ear. 2