There are significant differences in the diagnosis and treatment of headaches by race, socioeconomic level, and insurance status, although headache affects almost all races and ethnic groups alike, according to a study conducted by the faculty at UT Southwestern Medical Center.
Latinos are 50 percent less likely to be diagnosed with migraines than whites, and African-American men are the least likely to experience headache disorders nationwide, according to a review published in Neurology.
The under-treatment of headache in black patients is consistent with the available data on under-treatment of pain in these people, and is believed to be partly influenced by the misconception that African Americans are more biologically tolerant of pain. This misconception has led to inequalities in health care in the past, the study says.
We need to look at ourselves as health professionals and think, ‘What can we do to eliminate these inequalities and inequalities?’ “
Jessica Kiarashi, MD, assistant professor of neurology, lead author of the article, and chair of the Underserved Population in Headache Medicine section of the American Headache Society
Dr. Kiarashi worked with 15 other headache experts to review more than 50 studies on headache disorders and health care inequalities.
Part of the problem is the shortage of doctors who specialize in headache disorders, but major national deficiencies include systemic and institutional racism and the lack of health care in certain geographic areas.
Further findings were:
- Non-white children were less likely to receive headache medication and three times less likely to receive imaging than white children.
- Black children are less likely to go to emergency rooms for pediatric, sports-related head injuries.
- Lower income groups have a 60 percent higher migraine rate.
- Uninsured adults with migraines are twice as likely to receive evidence-based treatment and adults with statutory health insurance are one and a half times more likely than commercially insured adults with migraines.
Dr. Kiarashi said there is very little data on Asian Americans.
Headaches are also associated with a stigma, said Dr. Kiarashi. Headache disorders can significantly affect a person’s quality of life, making it difficult to focus in the workplace, and negative social selection of those with headache disorders can further disadvantage minorities in society, she said.
UT Southwestern Medical Center