Migraine in adolescents: association with socioeconomic status and family history.
OBJECTIVE
The influence of socioeconomic status on the prevalence of migraine is unknown in adolescents. Accordingly, we investigated the prevalence of migraine in a large sample of adolescents by sociodemographic features.


METHODS
A validated headache questionnaire was mailed to 120,000 households representative of the US population. All individuals in the household were interviewed (probands and their parents). We calculated sex-specific prevalence estimates of migraine in adolescents derived by age, race, urban vs rural residence, household income, region of the country, and parental status of migraine, using log-linear models.


RESULTS
A total of 32,015 adolescents were identified. Surveys were returned by 18,714 of them (58.4% response rate). The 1-year prevalence of migraine was 6.3% (5.0% in boys and 7.7% in girls). The prevalence was higher in girls than in boys older than 12 and in whites than African Americans. In families with an annual income lower than $22,500, the adjusted prevalence of migraine in adolescents without a parental history of migraine was 4.4%; in families earning $90,000 or more, it was 2.9% (OR = 0.49, 95% CI 0.38 to 0.63). In adolescents with a parental history of migraine, the prevalence in the lower vs the higher income group was 8.6% vs 8.4% (OR = 0.97, 0.81 to 1.15).


CONCLUSIONS
In adolescents with family history of migraine, household income does not have a significant effect, probably because of the higher biologic predisposition. In those without a strong predisposition, household income is associated with prevalence. This suggests social causation rather than social selection, highlighting the need for exploration of environmental risk factors related to low income and migraine and the search for specific comorbidities and stressors in this group.
Bigal
M E
ME
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA. mbigal@aecom.yu.edu
Lipton
R B
RB
Winner
P
P
Reed
M L
ML
Diamond
S
S
Stewart
W F
WF
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D004363:Drug Utilization; D004777:Environment; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics / Q000517:prevention & control / Q000523:psychology; D004366:Nonprescription Drugs / Q000627:therapeutic use; D010290:Parents; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012494:Sampling Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D013312:Stress, Physiological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data
D000700:Analgesics; D004366:Nonprescription Drugs