Is there an association between disease ignorance and self-rated health? The HUNT Study, a cross-sectional survey

OBJECTIVE To explore whether awareness versus unawareness of thyroid dysfunction, diabetes mellitus or hypertension is associated with self-rated health. DESIGN Large-scale, cross-sectional population-based study. The association between thyroid function, diabetes mellitus and blood pressure and self-rated health was explored by multiple logistic regression analysis. SETTING The second survey of the Nord-Trøndelag Health Study, HUNT2, 1995-1997. PARTICIPANTS 33 734 persons aged 40-70 years. PRIMARY OUTCOME MEASURES Logistic regression was used to estimate ORs for good self-rated health as a function of thyroid status, diabetes mellitus status and blood pressure status. RESULTS Persons aware of their hypothyroidism, diabetes mellitus or hypertension reported poorer self-rated health than individuals without such conditions. Women with unknown and subclinical hypothyroidism reported better self-rated health than women with normal thyroid status. In women and men, unknown and probable diabetes as well as unknown mild/moderate hypertension was not associated with poorer health. Furthermore, persons with unknown severe hypertension reported better health than normotensive persons. CONCLUSIONS People with undiagnosed but prevalent hypothyroidism, diabetes mellitus and hypertension often have good self-rated health, while when aware of their diagnoses, they report reduced self-rated health. Use of screening, more sensitive tests and widened diagnostic criteria might have a negative effect on perceived health in the population.