A Review of Underserved and Vulnerable Populations in Headache Medicine in the United States: Challenges and Opportunities

VanderPluym, Juliana; Charleston, Larry; Stitzer, Michael E; Flippen, Charles; Armand, Cynthia E.; Kiarashi, Jessica

doi:10.1007/s11916-022-01042-w

Cited by 8 publications

(14 citation statements)

References 27 publications

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“…This finding may be partially related to a high rate of traumatic brain injury among AI/AN men 19 . The AI/AN community is also disproportionately impoverished, and American studies have indicated greater migraine incidence in those of lower socioeconomic status 20,21 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…19 The AI/AN community is also disproportionately impoverished, and American studies have indicated greater migraine incidence in those of lower socioeconomic status. 20,21 Though the literature on disparities in headache care based on ethnic background is inadequate, the existing data suggest that African American and Latinx people with migraine are less likely to seek medical care, receive an accurate diagnosis, have high-quality communication with their provider, and be offered appropriate treatment. 21,22 There is great need for scientific inquiry into the impact of intersectionality on headache burden and care.…”

Section: Migrainementioning

confidence: 99%

“…20,21 Though the literature on disparities in headache care based on ethnic background is inadequate, the existing data suggest that African American and Latinx people with migraine are less likely to seek medical care, receive an accurate diagnosis, have high-quality communication with their provider, and be offered appropriate treatment. 21,22 There is great need for scientific inquiry into the impact of intersectionality on headache burden and care. For instance, while there is evidence that providers underestimate pain experienced by women and African Americans, black women in America are impacted by a unique milieu of historic and ongoing injustice that makes understanding headache in this population more complex than simply adding up the disparities of women and African Americans.…”

Section: Migrainementioning

confidence: 99%

“…Impoverished, female, black, Hispanic, and Native patients affected by migraine and other headache disorders may be discouraged from seeking care as concordance between patient and provider demographics often leads to better communication across multiple domains. 21,60 Migraine is one of the most significant contributors to disability in the United States and worldwide with a particularly profound impact in premenopausal women. Among 21,143 individuals with migraine in a demographically representative sample of the U.S. population, the OVERCOME study found that over 40% of responders had moderate or severe migraine-related disability.…”

Section: Disability/costmentioning

confidence: 99%

“…19 The AI/AN community is also disproportionately impoverished, and American studies have indicated greater migraine incidence in those of lower socioeconomic status. 20 21…”

Section: Prevalence Incidence and Demographic Featuresmentioning

confidence: 99%

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The Epidemiology of Primary Headache Disorders

Kopel

Gottschalk

2022

Semin Neurol

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Defining the epidemiology of headache disorders is challenging given the prevalence of stigma and other harmful misconceptions about these diseases. Understanding the widespread impact of these disorders is essential when considering social and policy interventions to mitigate that impact. Tension-type headache (TTH) is still widely considered the most common primary headache disorder, but population-based estimates of its prevalence vary widely. Migraine remains the most common headache disorder in patients who present for clinical care. Prevalence estimates have remained fairly stable over the last two decades (oneyear-period-prevalence, US: 18% of women and 6% of men). Recent studies indicate that people who identify as American Indian/Alaskan Native (AI/AN) have the highest migraine prevalence of any ethnic group surveyed, particularly among AI/AN men (15% vs. <10%).Studies in the US also show an inverse relationship between income level and migraine incidence and prevalence, particularly for chronic migraine; factors mediating this relationship are difficult to define. There are many diseases comorbid with migraine, more so with migraine with aura. The burden of migraine is enormous: the Global Burden of Disease study indicates Migraine is the #1 cause of disability in women under age 50 and the #2 or 3 cause of disability worldwide.Further study is needed into underdiagnosis, undertreatment, and persistent stigma associated with headache disorders, especially in underserved communities. Stakeholders including patients, providers, and governing bodies are affected by the results of epidemiologic studies and should all have a role in crafting and evaluating thoughtful and relevant questions and hypotheses in this field.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Section: Migrainementioning

confidence: 99%

Section: Migrainementioning

confidence: 99%

Section: Disability/costmentioning

confidence: 99%

“…19 The AI/AN community is also disproportionately impoverished, and American studies have indicated greater migraine incidence in those of lower socioeconomic status. 20 21…”

Section: Prevalence Incidence and Demographic Featuresmentioning

confidence: 99%

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