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. 2023 Apr 4;24(1):37.
doi: 10.1186/s10194-023-01564-7.

Headache impact and socioeconomic status: findings from a study of the German Migraine and Headache Society (DMKG)

Britta Müller  1 , Charly Gaul  2 , Olaf Reis  3 , Tim P Jürgens  4 , Peter Kropp  5 , Ruth Ruscheweyh  6 , Andreas Straube  6 , Elmar Brähler  7   8 , Stefanie Förderreuther  6 , Jennifer Schroth  9 , Thomas Dresler  10   11
Affiliations

Headache impact and socioeconomic status: findings from a study of the German Migraine and Headache Society (DMKG)

Britta Müller et al. J Headache Pain. .

Abstract

Backgound: Headache disorders are not only among the most prevalent, they are also among the most disabling disorders worldwide. This paper investigates the association between headache impact on daily life and the socioeconomic status (SES) of headache sufferers.

Methods: Data stem from a random general population sample in Germany. Respondents who reported having headache for at least a year and were aged ≥ 18 years were included in the study. A standardized questionnaire addressing headache and headache treatment was filled in during the face-to-face survey. The impact of headache on daily life was measured using the German version of the Headache Impact Test (HIT-6).

Results: Higher headache impact was found in low and medium SES compared to high SES. After adjustment for sociodemographics, headache-related factors (analgesic use, headache duration, headache frequency, migraine diagnosis), depressive symptoms, physical inactivity and obesity, an increased odds ratio of having higher headache impact in low SES compared to high SES was found: OR = 1.83, 95% CI [1.43, 2.23], p = .014. When the interactions "SES*obesity", "SES*depressive symptoms", and "SES*physical inactivity" were added, the results showed a significant interaction effect of "SES*obesity". Obese persons with low SES were 3.64 times more likely to have higher headache impact than non-obese persons with low SES. No significant differences between obese and non-obese persons were found in the medium and high SES groups.

Conclusions: SES is an important factor that should not be neglected in headache awareness campaigns and headache treatment. Longitudinal studies are needed in the future to investigate whether lifestyle interventions, such as weight reduction, can help to reduce headache impact in people in lower SES.

Keywords: Headache impact; Obesity; Socioeconomic status.

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Conflict of interest statement

Charly Gaul received honoraria for consulting and lectures within the past three years from Allergan/AbbVie, Lilly, Novartis Pharma, Hormosan Pharma, Grünenthal, Sanofi-Aventis, Weber & Weber, Lundbeck, Perfood, and TEVA. His research is supported by a grant of the German Research Foundation (DFG). He does not hold any stocks of pharmaceutical companies. He is honorary secretary of the German Migraine and Headache Society. Tim P. Jürgens has served on advisory boards and/or has received honoraria for lectures from Alleregan, Grünethal, Hormosan, Lilly, Lundbeck, Novartis, Sanofi, and TEVA. Peter Kropp has received funding from Takeda, travel- and lecture fees from Novartis, Lilly, and Teva. Ruth Ruscheweyh has received travel grants and/or honoraria from Allergan/AbbVie, Hormosan, Lilly, Novartis and Teva. Andreas Straube has received honoraria for lectures and consultations within the past 3 years from Allergan, Allergosan, Bayer, Lilly, Novartis, Teva. Stefanie Förderreuther has received honoraria for lectures and consultations within the past 3 years from Allergan, Hormosan, Lilly, Novartis, Sanofi, TEVA. Thomas Dresler has received honoraria for consulting and lectures within the past 3 years from Hormosan Pharma, Novartis Pharma, and TEVA. Elmar Brähler, Britta Müller, Olaf Reis, and Jennifer Schroth declare that they have nothing to disclose.

Figures

Fig. 1
Fig. 1
Potential mechanism linking SES and headache impact, based on the model of Elkeles and Mielck [19]
Fig. 2
Fig. 2
Proportions of individuals in headache impact categories depending on SES
Fig. 3
Fig. 3
Average marginal effects (AMEs) of ordinal regression, model 4
Fig. 4
Fig. 4
Predicted logits for each SES group and Obesity (yes/ no) combination
See this image and copyright information in PMC

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