Hard of Hearing vs Deaf: What the Words Mean and Who Is Counted

Deaf vs hard of hearing: where WHO draws the line

The World Health Organization starts from a reference point. A person who can't hear as well as someone with hearing thresholds of 20 dB or better in both ears has hearing loss, and WHO names five grades of it: mild, moderate, moderately severe, severe and profound.

Its fact sheet then ties the two words to those grades. Hard of hearing covers hearing loss from mild to severe. Deaf people, in WHO's wording, mostly have profound hearing loss, which means very little or no hearing.

The difference is also one of communication. WHO writes that people who are hard of hearing communicate mainly through spoken language, and lists hearing aids, cochlear implants, other assistive devices and captioning among what they can use. Some deaf people, it adds, use sign language.

WHO keeps a third line for its world statistics: disabling hearing loss, set at more than 35 dB in the better hearing ear. That threshold serves global counts. This page applies none of these lines to any person, and no U.S. law on this page uses them to decide a case.

Hard of hearing or hearing impaired: what deaf organizations ask for

Deaf organizations write about the words, not about decibels. The National Association of the Deaf (NAD), in its guidelines for the media, asks writers to use "deaf," "hard of hearing," "deaf or hard of hearing," or "deaf and hard of hearing." It calls deaf-mute, hearing impaired and hearing disabled outdated and inaccurate.

The World Federation of the Deaf (WFD) says the same from the international side. Its FAQ gives deaf or deaf people as the preferred term, and says a person with some hearing loss may prefer to be identified as hard of hearing. WFD and the International Federation of the Hard of Hearing, it adds, have agreed that hearing-impaired should not be used.

Neither text attaches a hearing level to a word, and WFD leaves the choice to the person. Language is part of that choice: the National Institute on Deafness and Other Communication Disorders (NIDCD) describes American Sign Language as a complete, natural language with the same linguistic properties as spoken languages.

What the ADA requires for people who are deaf or hard of hearing

The Americans with Disabilities Act doesn't ask which word a person uses. The Justice Department's guidance on effective communication covers people with vision, hearing or speech disabilities, under rules that went into effect on March 15, 2011. Covered entities must provide auxiliary aids and services when needed to communicate effectively.

For people who are deaf or have hearing loss, the guidance lists a qualified notetaker; a qualified sign language, oral, cued-speech or tactile interpreter; real-time captioning; and written materials. A hard of hearing person who follows speech may need captioning, while a deaf person who signs may need an interpreter: the rule turns on the communication, not on the label.

Two points come up often. A covered entity can't require a person to bring someone to interpret for them. And state and local governments, under title II, must give primary consideration to the aid or service the person asks for.

What counts as a disability for benefits, at work or at school is a separate question, answered on is hearing loss a disability.

Hard of hearing statistics: Census 2025 counts by state

The American Community Survey asks one question that covers both groups: whether a person is deaf or has serious difficulty hearing. A yes is recorded as a hearing difficulty, and the question has stayed the same since it was introduced in 2008. It is a survey answer, not a hearing test result.

Table S1810 of the 2025 ACS 1-year estimates gives that count for every state, the District of Columbia and Puerto Rico, in the civilian noninstitutionalized population, each with the Census Bureau's margin of error. The table above lists all of them. The largest counts are in California (1,231,084), Texas (1,090,857) and Florida (918,659), the three states with the largest populations in the same table; California's is 38,904,463.

Because counts follow population, read each one next to its state's population. Wyoming counted 31,490 people with a hearing difficulty out of 578,660, more than the District of Columbia's 14,926 out of 682,472, though the District has more residents.

The margins matter most for small places. The District's estimate carries a margin of error of 2,914, while California's much larger count carries 25,150; read a small state's figure as the estimate plus or minus its margin. Puerto Rico has its own row (180,136, margin 9,721). This page adds no national total and no percentage that the file doesn't publish.