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The Prevalence, Burden, and Treatment of Severe, Frequent, and Migraine Headaches in US Minority Populations: Statistics From National Survey Studies
Author(s) -
Loder Stephen,
Sheikh Huma U.,
Loder Elizabeth
Publication year - 2015
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12506
Subject(s) - migraine , medicine , headaches , ethnic group , national health interview survey , demography , population , pediatrics , psychiatry , environmental health , sociology , anthropology
Background The prevalence and burden of migraine and other severe headaches in the US population as a whole is well documented. Prevalence and treatment patterns in US racial and ethnic minorities, however, have received less attention. We sought to assemble and compare this information as identified in large, nationally representative studies. Methods We searched for summary statistics from studies performed in the U nited S tates between 1989 and 2014. Included studies had to provide population‐based, nationally or broadly representative information on the prevalence, burden, or treatment of severe or frequent headache or migraine in adult US B lacks, H ispanics, N ative A mericans, or A sians. Results Nine studies were included in the review. Prevalence data from the N ational H ealth I nterview S urvey ( NHIS ) provide the most comprehensive information for major racial and ethnic groups. The average prevalence of severe headache or migraine from 2005 to 2012 NHIS was 17.7% for N ative A mericans, 15.5% for W hites, 14.5% for H ispanics, 14.45% for B lacks, and 9.2% for A sians. Severe headache or migraine prevalence was higher in females of all races and ethnic groups compared with males and across all included studies. Female to male prevalence ratios from the 2005‐2012 NHIS were 2.1 for W hites, 2.5 for H ispanics, 2.1 for B lacks, and 2.0 for A sians. Among those with chronic migraine (≥15 days of headache per month), prevalence data from the A merican M igraine P revalence and P revention study showed that the prevalence of chronic migraine was highest in H ispanic women (2.26% compared with 1.2% for W hite females), whereas W hite males had the lowest prevalence at 0.46%. Data from the N ational H ospital A mbulatory C are S urvey and N ational A mbulatory C are S urvey show that H ispanics make only 89.5 annual ambulatory care visits per 10,000 population at which they receive a diagnosis of migraine, compared with 176.3 for W hites and 133.2 for B lacks. In contrast, visit rates resulting in a diagnosis of nonspecific headache were more comparable across all groups. Only one study obtained information on selected subgroups within H ispanic and A sian populations. This showed that differences among these subgroups, which suggest composite prevalence estimates for broadly defined racial and ethnic groups such as A sians, may conceal meaningful differences in subgroups, such as V ietnamese or F ilipinos. Conclusions In the U nited S tates, migraine prevalence is highest among N ative A mericans, then W hites, followed closely by H ispanics and B lacks. A sians have the lowest prevalence of severe, frequent headache or migraine of the major racial or ethnic groups. Differences in diagnosis and treatment of headache and migraine may indicate racial and ethnic disparities in access and quality of care for minority patients.