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We aimed to update the prevalence estimates of hearing loss in older adults in England using a nationally representative sample of adults aged 50 years old and older. A comparative cross-sectional study design was implemented. Hearing loss was defined as ≥35 dB HL at 3.0 kHz, as measured via Hearcheck in the better-hearing ear. We compared the estimates based on the English census in 2015 to estimates from psychoacoustic hearing data available for 8,263 participants in the English Longitudinal Study of Ageing (ELSA) Wave 7 (2014–2015). Marked regional variability in hearing loss prevalence was revealed among participants with similar age profiles. The regional differences in hearing outcomes reached up to 13.53% in those belonging to the 71–80 years old group; the prevalence of hearing loss was 49.22% in the North East of England (95%CI 48.0–50.4), versus 35.69% in the South East (95%CI 34.8–36.50). A socio-spatial approach in planning sustainable models of hearing care based on the actual populations’ needs and not on age demographics might offer a viable opportunity for healthier lives. Regular assessment of the extent and causality of the population’s different audiological needs within the country is strongly supported.