Racial disparities exist across many aspects of the healthcare system, including migraine diagnosis and care.
In recent years, advocacy groups and researchers have taken an interest in identifying the causes of racial differences in migraine, including the impacts on care and possible solutions. Researchers have found disparities between people of different races in their experiences of:
- seeking out care
It is possible to address racial disparities by educating those working in medicine and promoting greater diversity in medical schools and clinical trials. Learning to self-advocate can also help.
Disparities in migraine care often begin at the point of seeking out care for headaches and other symptoms.
According to the American Migraine Foundation (AMF), 46% of Black people with headaches seek care compared with 72% of white people.
The AMF identifies several reasons for this disparity, noting that the following factors can affect people belonging to historically marginalized groups:
- lack of access to healthcare
- economic issues
- mistrust of the medical community
- lack of representation in the medical community
For example, the study showed that Asian people have the lowest prevalence of migraine, with the condition affecting 9.2% of this population. In contrast, migraine has a prevalence of 17.7% among Native American people, 15.5% among white people, 14.5% among Hispanic people, and 14.45% among Black people. The researchers note that this disparity may reflect reticence around seeking care or issues related to access to and quality of care.
Looking beyond studies of migraine, systemic bias plays a role in healthcare disparities in general.
Where possible, a person should educate themself about migraine. This can help when seeking care, as the person can help guide the conversation, ask appropriate questions, and mention symptoms that may be important for the doctor to know.
When it comes to diagnosing migraine, underdiagnosis
According to the AMF, there is a large disparity in diagnosis rates between white people and Black people experiencing headaches. The organization notes that:
- 70% of white people living with headaches get a migraine diagnosis
- 40% of Black people living with headaches get a migraine diagnosis
- Hispanic people living with headaches have a 50% lower chance of a migraine diagnosis compared with white people
Without a diagnosis, people living with migraine cannot get specific care for the condition, which leads to less positive outcomes and a lower quality of life.
According to a 2021 review, disparities in diagnosis occur due to a variety of reasons, including:
- socioeconomic factors
- differences in insurance status
- disparities in geographic locations
Education is key to addressing racist treatment in the healthcare system.
Historically, people have incorrectly associated Black people with a higher pain tolerance, which translates to differences in treatment between people of different races.
Even medical studies have exhibited bias. For instance, an
In a 2017 study, researchers noted that in comparison with non-Hispanic white people, African American people experience:
- more frequent and severe migraine
- a higher likelihood of developing chronic migraine
- higher rates of resulting depression
- a lower quality of life
In spite of this, the AMF states that only 14% of Black people living with migraine receive prescriptions for acute migraine. In comparison, 37% of white people living with migraine receive acute migraine care.
In other words, racial differences contribute to a lack of both preventive care and treatment during an acute attack. Improper treatment leads to less positive treatment outcomes and a lower quality of life.
Addressing inequality in migraine diagnosis and care requires broad efforts across the medical field.
A 2021 review identified several steps, including:
- addressing health literacy
- improving public education
- optimizing and improving telemedicine
- engaging in community outreach to educate healthcare professionals working in primary care
- increasing efforts to recruit underrepresented groups in headache research
- training providers in cultural sensitivity and competence
- improving advocacy
- providing training on implicit bias
The AMF provides several free guides to people living with migraine that address:
- what to do after diagnosis
- how to self-advocate in the emergency room
- how to talk with a doctor about migraine
An important step for anyone living with migraine is to learn as much as possible about the disorder. Doing so can help them shape conversations with doctors and self-advocate for their care.
A person’s race can affect their ability to get a diagnosis and receive proper care for migraine. Several factors contribute to the differences in how people of different races receive migraine support. These include racial bias, a lack of access to healthcare, and a low quality of care.
A lack of support can lead to less positive outcomes, including ineffective treatment, higher rates of depression, and a reduced quality of life. A person should consider taking the time to learn as much as possible about migraine. A good understanding of the condition can help people better advocate for themselves.