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Migraine As a Public Health Problem

I hope you’ve had a chance to read about the groundbreaking report, “Atlas of Headache Disorders and Resources in the World 2011,” issued by the World Health Organization (WHO) and Lifting the Burden.

This report represents the most ambitious attempt, to date, to collect and distribute information on the global public health burden of headache disorders. Headache disorders cause tremendous costs to society, in terms of pain, disability, damaged quality of life, and productivity loss. This report is an important step to attracting the attention of policymakers who have, so far, ignored the problem of head pain.

But, as the authors of this report note, there is so much more work to be done!

The report identifies three overarching barriers to better care for headache patients, described as clinical, social or political/economic. I’ve provided a brief description of each and a modest suggestion for future research so that we can better understand how to overcome each of these barriers.

Clinical barriers: The authors noted that healthcare providers often don’t have the knowledge to provide effective headache management. I agree, more education ought to be done. But if 50% of people have some experience with a headache disorder, then perhaps all primary care physicians ought to be trained to ask patients about headache symptoms as part of a routine check-up, in much the same way that they ask about other matters of public health, like exercise, and seat belt habits, etc.

Social barriers: As we’ve talked about before on this blog, there’s such little awareness of headache among the general public. People don’t think that headache disorders are serious. But we don’t know much about how these social barriers work. Do people in pain diminish their own symptoms? Or do they worry that they won’t be taken seriously? More research needs to be done so that we understand why people don’t go to their doctors even when they’re in a lot of pain.

Political/economic barrers: Most policymakers don’t recognize headache disorders as a serious problem and this report is an excellent first step to attracting their attention. But if I were a policymaker reading this report, I’d want to know where I ought to be investing my money first. Public health burden is not evenly distributed across all types of headache disorders. Where am I going to get the most bang for my buck? It may be that a small group of chronic headache patients (perhaps people with medication overuse headache) are causing a disproportionate amount of the ‘days lived with disability.’ Alternatively, perhaps it’s easier and more cost-effective to launch a program that educates those people who have minor headache problems and self-medicate.

In just a few days, I’m heading to Washington, DC for the annual Headache on the Hill to talk to my legislators about improving care for headache disorders. This is a great report. I can’t wait to tell them about it.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Lynne Schultz
    8 years ago

    40 years with migraine…over the last decade they’ve been chronic. I would love to see headache disorders truly recognized for the life changers that they are!

  • Eduard Lahmann
    8 years ago

    When I was in college with three roommates in a house owned by an ex high school football coach. Ex because of migraines and going back to college to be a dentist! Life changing you bet.

  • Headache Recovery
    8 years ago

    IMHO, the medication overuse disorder diagnosis is, well, overused. I have had doctors diagnose that — and then when I get a neck massage by a good therapist, all of a sudden no more headaches for a couple of weeks. I’ve been seeing doctors for two decades about migraine and neck pain (my neck is just one of many triggers). It’s interesting to me that not doctor has ever offered the simplest therapies like vitamin B12 and magnesium injections — or discussed nutrition in any meaningful way. The preventative drugs they offer create their own host of side effects. We desperately need migraine research.

  • Suzanne Johnson
    8 years ago

    Unless you have migraine disease or lived with a family member with the disease, you can not begin to understand it. So we need to educate the ignorant and close minded.

  • Janet Geddis
    8 years ago

    I’m late in reading this, Joanna, but it’s great. Thanks also for the link to the report.

  • Kristen Davidson
    8 years ago

    we need to get the word out there..our legislators really need to take innitiative.

  • Carrie Coulter Nelson
    8 years ago

    This is something desperately needed!

  • Laura
    8 years ago

    Regarding social barriers, I often do not go to my doctor when I am in a lot of pain because I am concerned about the impact it may have on my job. I suffer from migraines on a near daily basis. I am fortunate to share an office with a co-worker who understands. She doesn’t mind if I turn the overhead lights off. So I just try my best to get through the day. I often think of trying to get in to see my neurologist when it is super painful, but I have only been at this job for 5 months and I do not want to take too much time away for last minute doctor appointments. I do not want my new manager to think I cannot handle my work – because I really love this work. So I suffer in silence. I wish doctors kept some evening or weekend hours. I cannot afford anymore emergency room visits.

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