article: The report indicates nearly a quarter of men and a sixth of women over the age of 55 who think they hear well actually have a hearing loss. And less than a third of all adults with a hearing loss use a hearing aid. The charity Action on Hearing Loss said it took most people a decade to seek help. It is the first time the annual health survey, conducted by NatCen Social Research, has compared people's perceptions about their hearing with the results of actual tests. Dr Jennifer Mindell, from UCL and one of the authors of the section on hearing, said the findings were worrying. She told the BBC: "Whether people are in denial or just unaware of what they can't hear we don't know." She said about half of the people who had said they had "great difficulty" hearing still did not use a hearing aid. Dr Mindell said: "People think it's a normal part of ageing, and some don't want a hearing aid as they feel there's a stigma attached in a way that people don't with glasses." Untreated hearing loss can lead to social exclusion due to the restrictive effect on conversation. Dr Mindell said it was a "cause for concern" and there was a link between untreated hearing loss and poor mental health. The report suggests: Gemma Twitchen, an audiologist with the charity Action on Hearing Loss, said: "Reluctance to acknowledge hearing difficulties is far more common than we might think - on average it takes people 10 years to seek help for hearing loss. "Early diagnosis is key, and hearing aids are vital in ensuring people can continue to communicate better with friends and family. "We would urge anyone that is concerned about their hearing to take our free hearing check." Follow James on Twitter.
summary: Around two million people who need a hearing aid do not even realise they have problems, the annual health survey for England suggests.