Department of Neurology, Graham Headache Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Division of Headache, Department of Neurology, Graham Headache Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Headache. 2021 Jan;61(1):60-68. doi: 10.1111/head.14024. Epub 2020 Dec 21.
Accurate, up-to-date estimates of the burden of migraine and severe headache are important for evidence-based decision-making about workforce needs and the distribution of health resources. We used data from US government health surveys to report the prevalence, trends, and impact of this condition by age, sex, and poverty status.
We identified the most recent, publicly available summary statistics from the National Hospital Ambulatory Medical Care Survey, the National Ambulatory Medical Care Survey, and the National Health Interview Survey. We extracted and compiled relevant information from each study, with an emphasis on sex, age, and economic-related statistics.
The age-adjusted prevalence of migraine and severe headache in the United States has remained stable over many years. In 2018, the age-adjusted prevalence was 15.9% across all adults. The sex ratio also remains stable, with 21% of women and 10.7% of men affected. Migraine continues to be an important public health problem, accounting for roughly 4 million emergency department (ED) visits in 2016, when headache was the fifth most common reason for an ED visit overall and the third most common reason for ED visits in females 15-64. Migraine also accounted for over 4.3 million office visits. Many adults with migraine or severe headaches are disadvantaged. In 2018, for example, roughly 40% of US adults with migraine were unemployed, and a similar proportion were classified as poor or "near poor." Roughly one in five had no health insurance and about a third had a high school education or less.
Migraine and severe headaches are a serious public health issue in the United States, with the highest impact in women of childbearing age and those of lower socioeconomic status. Socioeconomic disadvantages also are highly prevalent among those with headaches. The economic consequences of the current coronavirus pandemic are likely to exacerbate all of these inequities. Increased attention to this high impact chronic pain condition, and improved funding for treatment provision and research, are warranted to reduce the future burden of disease.
准确、最新的偏头痛和严重头痛负担估计对于基于证据的劳动力需求决策和卫生资源分配非常重要。我们使用美国政府健康调查数据，按年龄、性别和贫困状况报告了这种疾病的流行率、趋势和影响。
我们从国家医院门诊医疗保健调查、国家门诊医疗保健调查和国家健康访谈调查中确定了最新的、公开可用的汇总统计数据。我们从每项研究中提取并编译了相关信息，重点是性别、年龄和经济相关统计数据。
多年来，美国偏头痛和严重头痛的年龄调整患病率保持稳定。2018 年，所有成年人的年龄调整患病率为 15.9%。性别比例也保持稳定，女性患病率为 21%，男性为 10.7%。偏头痛仍然是一个重要的公共卫生问题，2016 年约有 400 万次急诊就诊是因为头痛，头痛是总体上急诊就诊的第五大常见原因，也是 15-64 岁女性急诊就诊的第三大常见原因。偏头痛也导致了超过 430 万次的门诊就诊。许多偏头痛或严重头痛患者处于不利地位。例如，2018 年，约 40%的美国偏头痛患者失业，约有同样比例的人被归类为贫困或“接近贫困”。大约五分之一的人没有医疗保险，约三分之一的人只有高中学历或以下。
偏头痛和严重头痛是美国的一个严重公共卫生问题，对育龄妇女和社会经济地位较低的人群影响最大。社会经济劣势在头痛患者中也非常普遍。当前冠状病毒大流行的经济后果可能会加剧所有这些不平等现象。需要更多关注这种高影响的慢性疼痛疾病，并为治疗提供和研究提供更多资金，以减轻未来的疾病负担。
