First-ever Study Looks At Impact Of Family Income On Prevalence Of Migraine In Adolescents

Led by Dr. Marcelo Bigal, assistant professor of neurology, the Einstein researchers mailed a headache questionnaire to 120,000 households encompassing 257,399 residents--a sample representative of the U.S. population with respect to gender, age and geographic region. More than 32,000 teens were identified in this sample, and more than half of them (58.4 percent) answered the questionnaire.

It is well known that heredity strongly influences whether someone will develop migraine headaches. So when this study looked at teens whose parents suffered from migraines, the prevalence of teens suffering one or more migraines in the previous year was nearly the same in lower vs. higher income groups--8.6 percent vs. 8.4 percent, respectively.

But when the Einstein researchers focused on those teens without a strong family predisposition for migraines, they found that household income was strongly associated with migraine prevalence: In families with annual incomes of less than $22,500, the prevalence of migraines in teens was 4.4 percent; by contrast, the migraine prevalence among teens in households earning $90,000 or more was only 2.9 percent.

"It would seem that for those teens who have a genetic predisposition for migraine, the stressful life events related to income don't matter," says Dr. Bigal. "They're more likely than other teens to get migraine regardless of their socioeconomic status, since they are predisposed. But for teens without a strong predisposition, reflected by the absence of migraine in first-degree relatives, family income factors into the prevalence of migraine, particularly among those teens whose families have low income."

Dr. Bigal notes that this finding correlates with migraine prevalence for adults, which is consistently higher among people with lower income and less education. "Our study also suggests that we should explore environmental risk factors, such as stressful events and nutrition, as they relate to low income and migraine to understand how we might reduce the occurrence of migraine among these individuals."

In addition to Dr. Bigal and colleagues at Albert Einstein College of Medicine and its University Hospital Montefiore Medical Center, researchers from the following institutions took part in the study: The New England Center for Headache, Stamford, CT; The Palm Beach Headache Center, Palm Beach, FL; Vedanta Research, Chapel Hill, N.C.; The Diamond Headache Center, Chicago, IL; and The Center for Health Research and Rural Advocacy, Danville, PA.