June is Migraine and Headache Awareness Month: Who shoulders migraine burden?

Naveed Saleh, MD, MS, for MDLinx | June 12, 2018

June is National Migraine and Headache Awareness Month, and is now a federally recognized health observance. Worldwide, migraine is the third most common disease, and affects both adults and children.

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Celebrate National Migraine and Headache Awareness Month in June

Worldwide, migraine is the third most common disease and headache has consistently ranked as either the fourth or fifth most common cause for emergency department visits.

However, the disadvantaged and disenfranchised are disproportionately burdened by migraine and severe headache, according to a recent targeted systematic review published in Headache.

“Consistent with prior studies, we found that migraine disproportionately affects women and several other historically disadvantaged segments of the population,” wrote primary author Rebecca Burch, MD, Graham Headache Center, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA. “These populations likely have reduced access to health care and treatment for their headaches in addition to being more exposed to triggers and other factors that can aggravate or produce headache.”

The researchers analyzed three recent US population-based surveys to refresh prior estimates of the frequency of self-reported migraine and severe headache. Furthermore, they aimed to identify the overall and sex-specific burden and treatment of these illnesses and “extracted and summarized data from each study over time and as a function of demographic variables.”

Specifically, the researchers performed cross-sectional studies of the National Health Interview Study (NHIS), the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the National Ambulatory Medical Care Survey (NAMCS). They extracted data on age, sex, and race/ethnicity.

They found that the prevalence of self-reported migraine and severe headache during a 3-month period was 15.3% overall, 9.7% in men, and 20.7% in women. This prevalence has remained stable during a 19-year period.

The following segments of society were most affected by migraine and severe headache:

  • American Indians or Alaska natives
  • Unemployed
  • Women aged 18 to 44 years
  • Families making under $35,000 per year
  • Elderly and those with disabilities

The team found that over time, headache has consistently ranked as either the fourth or fifth most common cause for emergency department visits, accounting for 3% of such visits annually. Of note, among reproductive-aged women, headache is the third most common cause of emergency visits.

One potential limitation of this study is that the researchers assessed migraine and severe headaches using a cross-sectional design, examining headache at a single point in time with little causality. Furthermore, the researchers relied on self-reported headache data, which may be biased.

“Severe headache and migraine remain important public health problems that are more common and burdensome for women, particularly women of childbearing age, and other historically disadvantaged segments of the population,” concluded the authors. “These inequities could be exacerbated if new high-cost treatments are inaccessible to those who need them most.”

Support increased awareness of migraines, headaches

In addition to combating the stigma sometimes associated with migraines and headaches and raising awareness, the goals of Migraine and Headache Awareness Month include:

  • Gain recognition of headache pain as a legitimate condition.
  • Encourage individuals with headache or migraine to seek care from a healthcare provider for proper diagnosis and treatment.
  • Educate those affected by migraine and headache on new treatments available.

This year’s theme is “The Art of Managing Your Headache,” in recognition of how personalized treatments can and should be, and that they differ from person to person. To help raise awareness, the National Headache Foundation encourages everyone to wear purple and show their support.

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