Background Socioeconomic and epidemiological effects of hearing impairment have been investigated in rich countries. But in most of the developing world, including middle income countries of Southeast Asia, evidence is still quite scarce. This study examines the association between hearing impairment and health outcomes in Thailand.

Methods Data derived from a cohort of 87 134 Open University adults residing throughout Thailand. Multivariate logistic regression was used for analysis reporting ORs and CIs. Population attributable fractions were estimated from exposure prevalence among controls and ORs.

Results Approximately 8.5% of cohort members reported trouble hearing, 0.13% reported being deaf, with increasing prevalence associated with older age. After adjusting for age and sex, poor self-assessed health was strongly associated with some trouble hearing [OR=2.70, 95% CI 2.48 to 2.93] and deafness [OR=3.08, 95% CI 1.73 to 5.50]. Poor psychological health was also strongly associated with some trouble hearing [OR=2.25, 95% CI 2.12 to 2.39] and deafness [OR=2.43, 95% CI 1.56 to 3.77]. Among the cohort the Population Attributable Fractions (PAF) for hearing impairment was 12.9% for poor self-assessed health, 9.8% for poor psychological health, 3.3% for metabolic disorders, and 4.1% for cardiovascular conditions. Almost all disease in the population was associated with the group with some trouble hearing because the number was much greater than the deaf group.

Conclusions Hearing loss in Thailand is common and strongly linked to several adverse health outcomes. There needs to be more attention on hearing impairment with regular check-ups and early detections. Psychological and medical counselling could help the hearing impaired to adopt strategies to prevent the various associated diseases.