PROJECT SUMMARY Hearing loss is one of the most common conditions among adults in the US. Currently, more than 30 million American adults experience some form of hearing loss and this number is expected to increase to 59.4 million people in the US by 2060. As this number increases, research focusing on health outcomes for individuals with hearing loss will become in- creasingly important. Existing research shows that those with hearing loss have poorer health outcomes compared to their hearing peers. The current literature shows that adults in the US with hearing loss were more likely to be in fair or poor health, have significantly more days of poor physical and mental health in the past month, and report serious psychologi- cal distress compared to those with little to no trouble hearing. American adults with hearing loss also had significantly lower health literacy than their hearing peers, which may affect health outcomes due to a lack of accessible health infor- mation and poor communication with health providers. Many adults first experience hearing loss in older ages as more health conditions begin to arise during this stage of life. In fact, approximately one in three people between the ages of 65 and 74 have hearing loss and nearly half of those older than 75 have difficulty hearing. Therefore, as hearing loss becomes a more common occurrence among aging adults, more research is needed to identify health disparities experienced by this population and understand factors that lead to such disparities, such as health literacy. Using nationally representative data from a US sample of older adults, the proposed F31 project will address this need with the following research aims: 1) Describe inequities in self-rated and physically assessed hearing loss by key sociodemographic factors; 2) Investigate risk differences in the relationship between hearing loss and cardiovascular outcomes by intersectional subgroups of sex/gen- der and race/ethnicity; and 3) Examine the mediating effect of health literacy in the relationship between hearing loss and cardiovascular outcomes. This research will consist of secondary data analysis using survey, physical measure, and bi- omarker data from the US Health and Retirement Study, a population-based longitudinal panel study that interviews and surveys adults aged 51 and older. The proposed training plan and mentoring team in this NIH Ruth L. Kirschstein Na- tional Research Service Award will support the successful completion of this project and will provide valuable knowledge and skills needed to establish a career as an independent researcher in the areas of aging and hearing loss. As hearing loss becomes a more common occurrence among aging individuals, research such as the proposed project will be foundational in establishing the causal pathways that lead to poorer cardiovascular outcomes and higher mortality among older adults with hearing loss, which will be key in helping to prevent, detect, diagnose, an...