Objective:

Background:

AI and Alaskan Natives have the highest prevalence of migraine and severe headaches compared to other racial groups. Nationally, AI represent 1.1% of the population. In Arizona, they represent 4.5% and account for 8% of AHCCCS recipients.

Design/Methods:

AHCCCS members aged 3 and older, who self-identified as AI, with an enrollment gap of no more than 45-days per year between 2018 and 2020 were included. Demographic characteristics, comorbid diagnoses, and social risk factors (based on ICD Z codes) were compared using ANOVA F-tests or Chi-squared tests, with multivariate logistic regression used to investigate associations.

Results:

Identifying as AI rather than White reduced the likelihood of receiving a migraine diagnosis (Pediatric 0.65 (95% CI: 0.59, 0.71) p<0.001; Adult 0.6 (95% CI:  0.58, 0.62) p<0.001) and migraine specific treatments (Pediatric 0.76 (95% CI: 0.59, 0.99) p=0.042; Adult 0.5 (95% CI: 0.46, 0.55) p<0.001) . Residing in an urban setting increased the likelihood of a migraine diagnosis (Pediatric 1.33 (95% CI: 1.08, 1.64) p=0.007; Adult 1.15 (95% CI: 1.07, 1.24) p<0.001). Urban residence did not affect the likelihood of pediatric AI receiving a migraine specific treatment but increased the likelihood for adult AI (1.71 (95% CI: 1.41, 2.07) p<0.001). Negative social factors decreased the likelihood of adult AI receiving a diagnosis of migraine (Ex. housing, basic amenity and environment factor 0.61 (95% CI: 0.53,0.71) p<0.001).

Conclusions:

AI were less likely to receive a migraine diagnosis and migraine-specific treatment. Interventions that address migraine healthcare disparities amongst AI are needed.