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What’s the Link? Socioeconomic Status and Chronic Migraine

In my last post, I talked about the link between income and migraine prevalence.

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 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] Buse, D., M. A, et al. (2010). “Journal of Neurology, Neurosurgery, and Psychiatry ” Sociodemographic and comorbidity profiles of chronic migraine and episodic migraine sufferers 81: 428—432.
[2] Blumenfeld, A., S. Varon, et al. (2010). “Disability, HRQOL and Resource Use Among Chronic and Episodic Migraineurs: Results from the International Burden of Migraine Study ” Cephalalgia 31(3): 301-315.

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

Comments

  • 5 years ago

    I’ve gotten episodic migraines since I was 9 or so. I was diagnosed with Fibromyalgia at 19.

    I had time to get a full ride scholarship and start a consulting business and have a career running multimillion dollar projects before I was diagnosed with CFS and Graves disease.

    Then I got married and had 2 children and the physical balance I’d had all these conditions in went to hell. I ended up coming out of the pregnancies with chronic daily migraines that clustered. The pain scale was bad enough that I couldn’t do my job, so we lost our house and went bankrupt. I’ve been on SSDI since 1996 and that is not acceptable for a type A personality.(It also isn’t a living wage; with my long term disability insurance included I’m below 60% of the median income for my county.)

  • annam
    7 years ago

    Concerning the severest, genetic migraine I wonder if there are not a number of factors effecting socioeconomic status. I think I may have had some migraine symptoms most of my life but did not have headaches till age 38. What I suspect were early symptoms helped me with a career in art. These symptoms however made me less employable in more normal endeavours. I thought I would always be able to at least entertain myself with my creativity but eventually the headaches did brain damage and basically took away my humanity. My mom started migraine hedaches in her mid-forties. She had been a military pilot and court reporter when it ws done in shorthand. She had a tremendous work ethic and “discipline” was her favourite word. Yet she frequently commented after the headaches started that she was glad she did not have to work as she wpould have been unemployable and undependable. Fortunately Mom and I married well. If I had not I would be on the street or in an institution. Like one neurologist said (while he was evaluating me for MS), when I told him I had never been pregnant, “Good, the gene stopped with you,” referring to migraine. (I only use an android phone. I can only see part of the field and part of what I typed. Can’t edit for errors. Sorry.)

  • Nancy Harris Bonk moderator
    7 years ago

    Your reply was just fine. I’m glad to hear you and your mom “married well” because that is a relief for anyone with a chronic illness. I too was brought up with a good work ethic and it pretty much brings me to my knees that I am on SSDI.

  • Elaine Gross
    7 years ago

    I count myself extremely fortunate that even though I have chronic migraine, I didn’t start suffering until I was 58. I managed to hang in there at work until I was 60 and then retired. I had worked for 32 yrs and had a good pension. I also applied for SSD ( early social security) so I get full benefits as if I worked until age 65. I am very grateful for both of those, and am glad I didn’t get this awful disease until later in life, although I suspect my frequent sinus infections over the years were probably migraines. I really feel for those who are young and suffer with this disease, I can’t imagine how tough it has to be. I empathize with fellow sufferers, especially the young ones.

  • Lisa Jurcich Kovach
    7 years ago

    I have been on Botox injections for 9 months now, and they have helped me so much. I have been able to go off 2 of my medications now, and feel so much better! I had 5 per week, and enjoy my life so much more now.

  • Dawn Raymond
    7 years ago

    Migraine is genetic, a disease. My migraines started as a child in episodes, and as I got older became chronic hormonally triggered. When younger they didn’t keep me from doing the things I wanted to do, school, married, children, work, etc. Ive always had health care and sought out many specialists. I continued to work under the FMLA laws for years, as time has gone on I live w/ chronic migraines and I am now disabled. I do have disabilty, but it is much less than when I worked. I feel this is the overwhelming majority of migraine sufferers issue. Heathcare alone is costly, then prescriptions… Migrianes in all ways produce vicious cycles for those that suffer.

  • Laura Price
    7 years ago

    I think there are a number of correlations here. First of all – folks who have a low income may also have poor medical care or NO regular medical care at all – they don’t have access to treatmets that can prevent and/or abort migraines. Its also my belief that stress is a major migraine trigger for many people and living a low income lifestyle can be extremely stressful – not knowing where the rent money is coming from, not being able to take a break when you need one, living in substandard housing and substandard neighborhoods. A healthy diet is important in migraine prevention, but unfortunately – if one is on a limited income, dietary choices are much more restricted and may be made up of high fat, hi carbs, hi salt and sugar and MSG loaded foods- an additional explanation for more low SES people being overweight. Lack of sleep is another trigger – lots of people with lower SES may be working at less desireable jobs with chaotic shifts and overnight work (I do overnight shifts and this and it has a huge impact on the number and severity of headaches) Finally the things that may be considered “extras and luxuries” such as music, dancing, nice exercise facilities, high quality counseling services – the things that are healthy and soothing – are usually out of financial reach for lower income people. I think it is a viscious cycle – one is not able to work as much, or in a high stress environment due to headaches, less money is earned, a more challenging lifestyle is encountered, fewer supportive modalities and less high quality medical care is available resulting in more heaaches and disability.

  • Shelly Cochran
    7 years ago

    not seeing it…

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