Objective:

To evaluate whether barriers to accessing specialized headache care exist among our diverse patient population in South Florida.

Background:

Disparities in migraine diagnosis and treatment disproportionately impact underserved populations, particularly racial and ethnic minorities. South Florida’s diverse population, with a substantial portion born outside of the U.S and speaking a language other than English at home, presents unique challenges. We analyzed data from 4,561 patients who visited our emergency departments with migraine and compared it with data from our headache subspecialty clinic over two years. By evaluating demographic characteristics including race, ethnicity, and primary language, we aimed to identify potential barriers to care.

Design/Methods:

We conducted a retrospective cross-sectional study comparing demographic data of 4,561 patients seen in our emergency department (ED) for migraine with 1,429 patients from our headache clinic over the course of 2 years. De-identified patient data was collected from electronic health records using Epic's SlicerDicer tool and included age, sex, race/ethnicity, and primary language. We used descriptive statistics to summarize the data testing for differences between both groups, utilizing chi-square to test for categorical data and t-test to test for continuous variables.

Results:

Significant disparities were found in follow-up care. Notably, Black or African-American patients (40.5% in the ED vs. 18.5% in the clinic, p < 0.001) and Spanish-speaking patients (13.5% in the ED vs 8.7% in the clinic, p < 0.001) were underrepresented in the headache clinic as compared to the emergency department.

Conclusions:

This study highlights significant racial and linguistic disparities in accessing headache specialty care. Targeted interventions to improve cultural competency, language access services, and community outreach are warranted to address these barriers and ensure equitable healthcare access for all migraine patients.