What’s the Link? Socioeconomic Status and Chronic Migraine

In the United States, migraine prevalence is higher in the lower income and education strata. The relationship between socioeconomic status (SES) and pain is even more pronounced when it comes to distinguishing people with an episodic migraine from people with chronic migraine.

In a recent study, Dawn Buse and her colleagues found that, compared with episodic migraine, people with chronic migraine were more likely to fall in a lower SES category. That is, they had statistically significant lower levels of household income, they were less likely to be employed full time and they were more likely to be disabled.

This relationship was supported in another study, this one by Andrew Blumenfeld and colleagues, which offered a comparison of chronic migraine and episodic migraine in nine countries across North America, Europe and the Asia/Pacific region. This study found that those with chronic migraine were more likely to be unemployed (as well as more overweight, more depressed and more anxious) than those with episodic migraine.

Although it’s clear that there’s a strong relationship between SES and chronic migraine, we don’t yet understand the nature of this relationship. Do people get chronic migraines and then lose income, thus experiencing what is called “downward drift”? Or do the stressors associated with living in a low SES group (for example, limited access to healthcare; little leisure time; poor nutrition; high stress) cause migraine to become chronic? If I had to, I would guess that the relationship goes both ways.

If you have chronic migraine and you’re living on disability, you might already have a pretty good idea about how SES and chronic migraine are linked. What do you think the relationship is?1,2

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