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Review
. 2022 Jun;26(6):415-422.
doi: 10.1007/s11916-022-01042-w. Epub 2022 Mar 26.

A Review of Underserved and Vulnerable Populations in Headache Medicine in the United States: Challenges and Opportunities

Juliana H VanderPluym  1 , Larry Charleston 4th  2 , Michael E Stitzer  3 , Charles C Flippen 2nd  4 , Cynthia E Armand  5 , Jessica Kiarashi  6
Affiliations
Review

A Review of Underserved and Vulnerable Populations in Headache Medicine in the United States: Challenges and Opportunities

Juliana H VanderPluym et al. Curr Pain Headache Rep. 2022 Jun.

Abstract

Purpose of review: This review will briefly summarize recent literature published on headache disparities in underserved and vulnerable populations. It will also report the personal observations of headache medicine providers working with underserved and vulnerable populations in the USA, specifically in an urban practice dedicated to patients in a safety net program and a rural practice dedicated to Native American patients.

Recent findings: Headache disorders are recognized as one of the most prevalent neurological conditions. People with headache and migraine encounter several barriers to obtaining appropriate care, which are magnified in vulnerable and underserved populations. Research has shown disparities in headache and migraine diagnosis, prevalence rates, treatment, and outcomes based on race, socioeconomic status, and geography. Continued research regarding disparities in headache medicine is required. Strategies to address the identified challenges, including structural competence and the underrepresented in medicine pipeline, are reviewed.

Keywords: Disparities; Headache medicine; Race; Socioeconomic; Underserved; Vulnerable.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. G. B. D. Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):459–80. https://doi.org/10.1016/S1474-4422(18)30499-X . - DOI
    1. Serving Vulnerable and Underserved Populations. 2021. https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/... . Accessed 3 Dec 2021.
    1. •• Kiarashi J, VanderPluym J, Szperka CL, Turner S, Minen MT, Broner S, et al. Factors associated with, and mitigation strategies for, health care disparities faced by patients with headache disorders. Neurology. 2021;97(6):280–9. https://doi.org/10.1212/WNL.0000000000012261 . Most recently published expansive review of disparities in headache medicine. - DOI - PubMed
    1. •• Burch R, Rizzoli P, Loder E. The prevalence and impact of migraine and severe headache in the United States: Figures and trends from government health studies. Headache. 2018;58(4):496–505. https://doi.org/10.1111/head.13281 . Provides epidemiological data on disparities in headache medicine based on government health studies. - DOI - PubMed
    1. Nicholson RA, Rooney M, Vo K, O’Laughlin E, Gordon M. Migraine care among different ethnicities: do disparities exist?. Headache. 2006;46(5):754–65. https://doi.org/10.1111/j.1526-4610.2006.00453.x . - DOI - PubMed - PMC

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