Socioeconomic and geographic inequalities in headache disability in Brazil: The 2019 National Health Survey

Abstract

Objective To map the socioeconomic and geographic inequalities in headache disability in Brazil. Background Headache disability and its social determinants are poorly investigated in Brazil. Methods This is a secondary, cross‐sectional analysis of the 2019 National Health Survey database, a representative sample of the Brazilian population. Working‐aged Brazilians (aged ≥14 years) were included in the analyses (n = 225,563). Headache disability was inquired through questions on the number of days the respondent was unable to perform customary daily activities in the past 2 weeks. Proportion estimates and the mean days lost were compared between socioeconomic categories. Sample weights were used. Results Among 14 disease‐related disability groups, headache disability (n = 1228) was the second most prevalent disability in adolescents and fifth among adults aged <50 years. In the headache disability sample, there was a higher proportion of females at 72.4% (95% confidence interval [CI] 68.5%–75.9%), with a mean (95% CI) age of 41.1 (40.1–42.0) years and days lost due to disability of 3.4 (3.2–3.6) days. The sociodemographic distribution across income strata (quartiles) of the headache disability sample showed the highest proportions at the lowest income quartile in the Northeast region (15.4%, 95% CI 12.8%–18.4%), for people of Brown color (17.5%, 95% CI 14.7%–20.7%), and with the lowest education level (l3.6%, 95% CI 11.3%–16.2%). Black people, those from the North region, and those with the lowest education level had more days lost than White people (mean [95% CI] 4.1 [3.5–4.6] vs. 3.1 [2.8–3.4] days, p = 0.008), those from the Southeast region (mean [95% CI] 3.8 [3.4–4.2] vs. 2.8 [2.4–3.3] days, p = 0.022), and people with the highest education level (mean [95% CI] 3.9 [3.6–4.2] vs. 2.8 [2.3–3.3] days, p = 0.005), respectively. Conclusion In Brazil, headache disability is one of the leading causes of disability and it is characterized by socioeconomic inequalities.

Trainee highlights

“…His PhD in Neuroepidemiology is from the University of Sao Paulo—USP (2022). Additionally, he is Co‐chair of the IHS Communication Committee (the former Electronic Media Committee), and a member of the Brazilian Headache Society's Physiotherapy and Physical Activity Committee as well as of the International Society for Physical Activity and Health (ISPAH) 3 …”