This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Relation to Age, Income, Race, and Other Sociodemographic Factors

Walter F. Stewart, PhD, MPH; Richard B. Lipton, MD; David D. Celentano, ScD; Michael L. Reed, PhD

JAMA. 1992;267(1):64-69.

Abstract
Objective.
—To describe the magnitude and distribution of the public health problem posed by migraine in the United States by examining migraine prevalence, attack frequency, and attack-related disability by gender, age, race, household income, geographic region, and urban vs rural residence.

Design.
—In 1989, a self-administered questionnaire was sent to a sample of 15000 households. A designated member of each household initially responded to the questionnaire. Each household member with severe headache was asked to respond to detailed questions about symptoms, frequency, and severity of headaches.

Setting.
—A sample of households selected from a panel to be representative of the US population in terms of age, gender, household size, and geographic area.

Participants.
—After a single mailing, 20468 subjects (63.4% response rate) between 12 and 80 years of age responded to the survey. Respondents and non-respondents did not differ by gender, household income, region of the country, or urban vs rural status. Whites and the elderly were more likely to respond. Migraine headache cases were identified on the basis of reported symptoms using established diagnostic criteria.

Results.
—17.6% of females and 5.7% of males were found to have one or more migraine headaches per year. The prevalence of migraine varied considerably by age and was highest in both men and women between the ages of 35 to 45 years. Migraine prevalence was strongly associated with household income; prevalence in the lowest income group (<$10 000) was more than 60% higher than in the two highest income groups ($30 000). The proportion of migraine sufferers who experienced moderate to severe disability was not related to gender, age, income, urban vs rural residence, or region of the country. In contrast, the frequency of headaches was lower in higher-income groups. Attack frequency was inversely related to disability.

Conclusions.
—A projection to the US population suggests that 8.7 million females and 2.6 million males suffer from migraine headache with moderate to severe disability. Of these, 3.4 million females and 1.1 million males experience one or more attacks per month. Females between ages 30 to 49 years from lower-income households are at especially high risk of having migraines and are more likely than other groups to use emergency care services for their acute condition.

(JAMA. 1992;267:64-69)

Author Affiliations
From the Departments of Epidemiology (Dr Stewart) and Health Policy and Management (Dr Celentano), The Johns Hopkins University, Baltimore, Md; the Department of Neurology, Albert Einstein College of Medicine, New York, NY (Dr Lipton); and Glaxo Inc, Research Triangle Park, NC (Dr Reed).

Footnotes
Reprint requests to Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205 (Dr Stewart).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Primary headache disorders in the Republic of Georgia: Prevalence and risk factors
Katsarava et al.
Neurology 2009;73:1796-1803.
ABSTRACT | FULL TEXT  

Migraine frequency and risk of cardiovascular disease in women
Klein and Spencer
Neurology 2009;73:e42-e43.
FULL TEXT  

Relationship between Migraine History and Breast Cancer Risk among Premenopausal and Postmenopausal Women
Li et al.
Cancer Epidemiol. Biomarkers Prev. 2009;18:2030-2034.
ABSTRACT | FULL TEXT  

Migraine in recurrent depression: case-control study
Samaan et al.
Br. J. Psychiatry 2009;194:350-354.
ABSTRACT | FULL TEXT  

Modern Management of the Migraine Headache
Pesaturo and Wooding
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2009;3:147-159.
ABSTRACT  

Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Topiramate for Migraine Prevention in Pediatric Subjects 12 to 17 Years of Age
Lewis et al.
Pediatrics 2009;123:924-934.
ABSTRACT | FULL TEXT  

Migraine in Postmenopausal Women and the Risk of Invasive Breast Cancer
Mathes et al.
Cancer Epidemiol. Biomarkers Prev. 2008;17:3116-3122.
ABSTRACT | FULL TEXT  

A high-density association screen of 155 ion transport genes for involvement with common migraine
Nyholt et al.
Hum Mol Genet 2008;17:3318-3331.
ABSTRACT | FULL TEXT  

Validity of the ID-Migraine screener in the workplace
Siva et al.
Neurology 2008;70:1337-1345.
ABSTRACT | FULL TEXT  

Impact of comorbidity on headache-related disability
Saunders et al.
Neurology 2008;70:538-547.
ABSTRACT | FULL TEXT  

Headache Therapy With Botulinum Toxin: Form Over Substance
Pakalnis and Couch
Arch Neurol 2008;65:149-151.
FULL TEXT  

Current Therapies in Childhood and Adolescent Migraine
Pakalnis
J Child Neurol 2007;22:1288-1292.
ABSTRACT  

Resource use associated with topiramate in migraine prophylaxis
Feliu et al.
Am J Health Syst Pharm 2007;64:1483-1491.
ABSTRACT | FULL TEXT  

Migraine and retinal microvascular abnormalities: The Atherosclerosis Risk in Communities Study
Rose et al.
Neurology 2007;68:1694-1700.
ABSTRACT | FULL TEXT  

January 30 Highlight and Commentary: Migraine: Not just your mother's headache anymore
Neurology 2007;68:319-319.
FULL TEXT  

How common are the "common" neurologic disorders?
Hirtz et al.
Neurology 2007;68:326-337.
ABSTRACT | FULL TEXT  

Twelve-Month Tolerability and Safety of Sumatriptan-Naproxen Sodium for the Treatment of Acute Migraine
Winner et al.
Mayo Clin Proc. 2007;82:61-68.
ABSTRACT | FULL TEXT  

Headache impact in patients with orofacial pain.
Mitrirattanakul and Merrill
Journal of the American Dental Association 2006;137:1267-1274.
ABSTRACT | FULL TEXT  

Assessing Health-Related Quality of Life in Children with Recurrent Headache: Reliability and Validity of the PedsQLTM 4.0 in a Pediatric Headache Sample
Connelly and Rapoff
J Pediatr Psychol 2006;31:698-702.
ABSTRACT | FULL TEXT  

The Associations Among Childhood Headaches, Emotional and Behavioral Difficulties, and Health Care Use
Strine et al.
Pediatrics 2006;117:1728-1735.
ABSTRACT | FULL TEXT  

The influence of estrogen on migraine: a systematic review.
Brandes
JAMA 2006;295:1824-1830.
ABSTRACT | FULL TEXT  

Clinical trials of acute treatments for migraine including multiple attack studies of pain, disability, and health-related quality of life
Lipton et al.
Neurology 2005;65:S50-S58.
ABSTRACT | FULL TEXT  

MIGRAINE
Barnes and Jayawant
EDUCATION AND PRACTICE 2005;90:ep53-ep57.
FULL TEXT  

Prevalence of bipolar symptoms in epilepsy vs other chronic health disorders
Ettinger et al.
Neurology 2005;65:535-540.
ABSTRACT | FULL TEXT  

Incidence of Primary Headache: A Danish Epidemiologic Follow-up Study
Lyngberg et al.
Am J Epidemiol 2005;161:1066-1073.
ABSTRACT | FULL TEXT  

Solution-Focused Treatment of Migraine Headache
Guterman et al.
The Family Journal 2005;13:195-198.
ABSTRACT  

Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries
Dalstra et al.
Int J Epidemiol 2005;34:316-326.
ABSTRACT | FULL TEXT  

Migraine, headache, and the risk of stroke in women: A prospective study
Kurth et al.
Neurology 2005;64:1020-1026.
ABSTRACT | FULL TEXT  

Long-term effects of migraine on cognitive function: A population-based study of Danish twins
Gaist et al.
Neurology 2005;64:600-607.
ABSTRACT | FULL TEXT  

Practice Parameter: Pharmacological treatment of migraine headache in children and adolescents: Report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society
Lewis et al.
Neurology 2004;63:2215-2224.
ABSTRACT | FULL TEXT  

Migraine and other headaches: Associations with Rose angina and coronary heart disease
Rose et al.
Neurology 2004;63:2233-2239.
ABSTRACT | FULL TEXT  

Increased frequency of migraine among women with endometriosis
Ferrero et al.
Hum Reprod 2004;19:2927-2932.
ABSTRACT | FULL TEXT  

Estrogens, Migraine, and Stroke
Bousser
Stroke 2004;35:2652-2656.
ABSTRACT | FULL TEXT  

Prevalence and impact of migraine and probable migraine in a health plan
Patel et al.
Neurology 2004;63:1432-1438.
ABSTRACT | FULL TEXT  

Depression and comorbidity in community-based patients with epilepsy or asthma
Ettinger et al.
Neurology 2004;63:1008-1014.
ABSTRACT | FULL TEXT  

Headaches in patients with systemic lupus erythematosus: a comparative study
Whitelaw et al.
Lupus 2004;13:501-505.
ABSTRACT  

Disruption of communication between peripheral and central trigeminovascular neurons mediates the antimigraine action of 5HT1B/1D receptor agonists
Levy et al.
Proc. Natl. Acad. Sci. USA 2004;101:4274-4279.
ABSTRACT | FULL TEXT  

Triptans in migraine: The risks of stroke, cardiovascular disease, and death in practice
Hall et al.
Neurology 2004;62:563-568.
ABSTRACT | FULL TEXT  

Somatic Symptoms in Primary Care: Etiology and Outcome
Khan et al.
Psychosomatics 2003;44:471-478.
ABSTRACT | FULL TEXT  

Lost Productive Time and Cost Due to Common Pain Conditions in the US Workforce
Stewart et al.
JAMA 2003;290:2443-2454.
ABSTRACT | FULL TEXT  

The prevalence of migraine in neurologists
Evans et al.
Neurology 2003;61:1271-1272.
ABSTRACT | FULL TEXT  

A self-administered screener for migraine in primary care: The ID MigraineTM validation study
Lipton et al.
Neurology 2003;61:375-382.
ABSTRACT | FULL TEXT  

Comorbidity of migraine and depression: Investigating potential etiology and prognosis
Breslau et al.
Neurology 2003;60:1308-1312.
ABSTRACT | FULL TEXT  

Patterns of health care utilization for migraine in England and in the United States
Lipton et al.
Neurology 2003;60:441-448.
ABSTRACT | FULL TEXT  

Drop Attacks and Vertigo Secondary to a Non-Meniere Otologic Cause
Ishiyama et al.
Arch Neurol 2003;60:71-75.
ABSTRACT | FULL TEXT  

Migraine and Meniere's disease: Is there a link?
Radtke et al.
Neurology 2002;59:1700-1704.
ABSTRACT | FULL TEXT  

Prevalence and clinical characteristics of migraine in France
Henry et al.
Neurology 2002;59:232-237.
ABSTRACT | FULL TEXT  

The central nervous system in systemic lupus erythematosus. Part 1. Clinical syndromes: a literature investigation
Jennekens and Kater
Rheumatology (Oxford) 2002;41:605-618.
ABSTRACT | FULL TEXT  

Migraine and tension-type headache: An assessment of challenges in diagnosis
Kaniecki
Neurology 2002;58:S15-20.
ABSTRACT | FULL TEXT  

Diagnostic lessons from the Spectrum Study
Lipton et al.
Neurology 2002;58:S27-31.
ABSTRACT | FULL TEXT  

Self-awareness of migraine: Interpreting the labels that headache sufferers apply to their headaches
Lipton et al.
Neurology 2002;58:S21-26.
ABSTRACT | FULL TEXT  

Migraine in the United States: Epidemiology and patterns of health care use
Lipton et al.
Neurology 2002;58:885-894.
ABSTRACT | FULL TEXT  

Diagnosis and Treatment of Migraine
Cady and Dodick
Mayo Clin Proc. 2002;77:255-261.
ABSTRACT  

Cluster headache: A prospective clinical study with diagnostic implications
Bahra et al.
Neurology 2002;58:354-361.
ABSTRACT | FULL TEXT  

Short-Wavelength Sensitivity Deficits in Patients With Migraine
McKendrick et al.
Arch Ophthalmol 2002;120:154-161.
ABSTRACT | FULL TEXT  

Migraine -- Current Understanding and Treatment
Goadsby et al.
NEJM 2002;346:257-270.
FULL TEXT  

Are headache patients who initiate their referral to a neurologist satisfied with the consultation? A population study of 927 patients--the North Norway Headache Study (NNHS)
Bekkelund and Salvesen
Fam Pract 2001;18:524-527.
ABSTRACT | FULL TEXT  

Headache Evaluation and Treatment by Primary Care Physicians in an Emergency Department in the Era of Triptans
Maizels
Arch Intern Med 2001;161:1969-1973.
ABSTRACT | FULL TEXT  

Children With Headache Suspected of Having a Brain Tumor: A Cost-Effectiveness Analysis of Diagnostic Strategies
Medina et al.
Pediatrics 2001;108:255-263.
ABSTRACT | FULL TEXT  

The Clinical Spectrum of Familial Hemiplegic Migraine Associated with Mutations in a Neuronal Calcium Channel
Ducros et al.
NEJM 2001;345:17-24.
ABSTRACT | FULL TEXT  

Lisinopril for migraine
Chen
CMAJ 2001;164:1337-1337.
FULL TEXT  

Prevalence of headache in an elderly population: attack frequency, disability, and use of medication
Prencipe et al.
J. Neurol. Neurosurg. Psychiatry 2001;70:377-381.
ABSTRACT | FULL TEXT  

The impact of migraine: Epidemiology, risk factors, and co-morbidities
Breslau and Rasmussen
Neurology 2001;56:S4-S12.
ABSTRACT | FULL TEXT  

Migraine-related disability: Impact and implications for sufferers' lives and clinical issues
Holmes et al.
Neurology 2001;56:S13-S19.
ABSTRACT | FULL TEXT  

Migraine Headache Associated With Latanoprost
Weston
Arch Ophthalmol 2001;119:300-301.
FULL TEXT  

New avenues in treatment of paediatric migraine: a review of the literature
Pakalnis
Fam Pract 2001;18:101-106.
ABSTRACT | FULL TEXT  

Efficacy and Safety of Acetaminophen in the Treatment of Migraine: Results of a Randomized, Double-blind, Placebo-Controlled, Population-Based Study
Lipton et al.
Arch Intern Med 2000;160:3486-3492.
ABSTRACT | FULL TEXT  

Menstrual cycle and headache in a population sample of migraineurs
Stewart et al.
Neurology 2000;55:1517-1523.
ABSTRACT | FULL TEXT  

Toward Evidence-Based Management of Migraine
Matchar et al.
JAMA 2000;284:2640-2641.
FULL TEXT  

The Diagnostic Value of Historical Features in Primary Headache Syndromes: A Comprehensive Review
Smetana
Arch Intern Med 2000;160:2729-2737.
ABSTRACT | FULL TEXT  

Mental Disorders and the Incidence of Migraine Headaches in a Community Sample: Results From the Baltimore Epidemiologic Catchment Area Follow-up Study
Swartz et al.
Arch Gen Psychiatry 2000;57:945-950.
ABSTRACT | FULL TEXT  

Practice parameter: Evidence-based guidelines for migraine headache (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology
Silberstein
Neurology 2000;55:754-762.
FULL TEXT  

Migraine, quality of life, and depression: A population-based case-control study
Lipton et al.
Neurology 2000;55:629-635.
ABSTRACT | FULL TEXT  

Evaluation of Migraineurs' Preferences for Naratriptan Over Conventional First-Line Agents
Powers et al.
Arch Fam Med 2000;9:753-757.
ABSTRACT | FULL TEXT  

The development of cutaneous allodynia during a migraine attack Clinical evidence for the sequential recruitment of spinal and supraspinal nociceptive neurons in migraine
Burstein et al.
Brain 2000;123:1703-1709.
ABSTRACT | FULL TEXT  

Multispecialty consensus on diagnosis and treatment of headache
Silberstein and Rosenberg
Neurology 2000;54:1553-1553.
FULL TEXT  

Headache and major depression: Is the association specific to migraine?
Breslau et al.
Neurology 2000;54:308-308.
ABSTRACT | FULL TEXT  

Chronic daily headache in Chinese elderly: Prevalence, risk factors, and biannual follow-up
Wang et al.
Neurology 2000;54:314-314.
ABSTRACT | FULL TEXT  

Human Hepatocytes in Primary Culture Predict Lack of Cytochrome P-450 3A4 Induction by Eletriptan In Vivo
Pichard-Garcia et al.
Drug Metab. Dispos. 2000;28:51-57.
ABSTRACT | FULL TEXT  

Increased brain serotonin synthesis in migraine
Chugani et al.
Neurology 1999;53:1473-1473.
ABSTRACT | FULL TEXT  

The prevalence and characteristics of migraine in a population-based cohort: The GEM Study
Launer et al.
Neurology 1999;53:537-537.
ABSTRACT | FULL TEXT  

The Challenge of Drug-Induced Aseptic Meningitis
Moris and Garcia-Monco
Arch Intern Med 1999;159:1185-1194.
ABSTRACT | FULL TEXT  

Burden of Migraine in the United States: Disability and Economic Costs
Hu et al.
Arch Intern Med 1999;159:813-818.
ABSTRACT | FULL TEXT  

Neurological complications of neurofibromatosis type 1 in adulthood
Creange et al.
Brain 1999;122:473-481.
ABSTRACT | FULL TEXT  

Sumatriptan Injection Reduces Productivity Loss During a Migraine Attack: Results of a Double-blind, Placebo-Controlled Trial
Cady et al.
Arch Intern Med 1998;158:1013-1018.
ABSTRACT | FULL TEXT  

Epidemiology of Tension-Type Headache
Schwartz et al.
JAMA 1998;279:381-383.
ABSTRACT | FULL TEXT  

Efficacy and Safety of Acetaminophen, Aspirin, and Caffeine in Alleviating Migraine Headache Pain: Three Double-blind, Randomized, Placebo-Controlled Trials
Lipton et al.
Arch Neurol 1998;55:210-217.
ABSTRACT | FULL TEXT  

A Comparison of Divalproex With Propranolol and Placebo for the Prophylaxis of Migraine Without Aura
Kaniecki
Arch Neurol 1997;54:1141-1145.
ABSTRACT  

A 27-Year-Old Woman With Migraine Headaches
Welch
JAMA 1997;278:322-328.
ABSTRACT  

Rizatriptan vs Sumatriptan in the Acute Treatment of Migraine: A Placebo-Controlled, Dose-Ranging Study
Visser et al.
Arch Neurol 1996;53:1132-1137.
ABSTRACT  

Ketorolac vs Chlorpromazine in the Treatment of Acute Migraine Without Aura: A Prospective, Randomized, Double-blind Trial
Shrestha et al.
Arch Intern Med 1996;156:1725-1728.
ABSTRACT  

Meniere's Disease: Etiologic Considerations
Parker
Arch Otolaryngol Head Neck Surg 1995;121:377-382.
ABSTRACT  

Migraine Prophylaxis With Divalproex
Mathew et al.
Arch Neurol 1995;52:281-286.
ABSTRACT  

Post-Concussion (Post-Trauma) Syndrome
Couch
Neurorehabil Neural Repair 1995;9:83-89.
 

Headache Classification
Landy and McGinnis
Arch Fam Med 1994;3:943-943.
ABSTRACT  

Prevalence of headache and migraine in schoolchildren
Abu-Arefeh and Russell
BMJ 1994;309:765-769.
ABSTRACT | FULL TEXT  

Pharmacologic Therapy, Nondrug Therapy, and Counseling Are Keys to Effective Migraine Management
Sheftell
Arch Fam Med 1993;2:874-879.
ABSTRACT  

Factors That Predict Antiphospholipid Immunoreactivity in Young People With Transient Focal Neurological Events
Tietjen et al.
Arch Neurol 1993;50:833-836.
ABSTRACT  

Undiagnosed Migraine Headaches: A Comparison of Symptom-Based and Reported Physician Diagnosis
Lipton et al.
Arch Intern Med 1992;152:1273-1278.
ABSTRACT