The Role of Discrimination on Migraine Disease Burden in African Americans
Mara Getz1, Larry Charleston IV2, Cynthia Armand3, Elizabeth Seng4
1Yeshiva University, Ferkauf Graduate School of Psychology, 2Michigan State University College of Human Medicine, 3Montefiore Medical Headache Center, 4Yeshiva University, Albert Einstein College of Medicine
Objective:

This study investigated the relationship between headache frequency, perceived discrimination (lifetime and in a medical setting), and migraine-specific quality of life among an African American (AA) sample.

Background:
Widespread disparities in migraine care exist by race/ethnicity, leading to poorer health outcomes in minoritized populations. AA are particularly affected and are less likely to seek healthcare for migraine.
Design/Methods:

Self-identified AA with an ICD-10 diagnosis of migraine, seen at a tertiary headache center within the last 12 months, were recruited via telephone and email to participate in a one-time online survey. Data collection included Item A of the Migraine Disability Assessment (MIDAS-A), the Migraine-Specific Quality of Life Questionnaire (MSQ) v2.1, the Brief Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV), and the Discrimination in Medical Settings (DMS) Scale. Pearson correlations evaluated bivariate relationships among variables.

Results:

Ninety-one individuals (94.5% female, 5.5% male), all identifying as Black and/or AA (72.5% Non-Hispanic, 27.5% Hispanic), ages 18 to 78 years (M = 38.49, SD = 12.58) participated. Higher levels of discrimination in medical settings were associated with increased headache days (MIDAS-A: r = 0.26, p < .05), while lifetime discrimination showed a weak non-significant association (r = 0.07, p > .05). Significant negative associations were observed between the PEDQ-CV and MSQ subscales: Role Function Restrictive (r = -.27, p < .05) and Emotional Function (r = -.23, p < .05). Meanwhile, DMS scores negatively associated with all MSQ subscales Role Function Restrictive (r = -0.28, p < .01), Role Function Prevention (r = -.23, p < .05), and Emotional Function (r = -0.23, p < .05).

Conclusions:

Discrimination, particularly in medical settings, is associated with increased headache frequency and decreased migraine-specific quality of life in AA with migraine. Addressing discrimination may help to build trust, encourage migraine care-seeking, and reduce disparities in AA patients with migraine.

10.1212/WNL.0000000000209113
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.