Racial, economic disparities in pediatric headache care highlight importance of follow-up

AUSTIN, Texas — Significant improvement was reported in children who have follow-up visits to a headache clinic, although Black patients and patients on Medicaid were less likely to complete these visits, according to data presented here.

“The prevalence of migraine is similar among white, Black and Hispanic groups in the U.S.; however, numerous disparities exist in the presentation to care for headache disorders, management and treatment,” Jessica A. Saunders, MD, a headache fellow at Cincinnati Children’s Hospital, told attendees. “Minimal research on these disparities has been done in children and adolescents, particularly presenting to tertiary headache centers.”

Researchers conducted a retrospective analysis of patients aged 6 to 17 years who had an initial visit to a headache clinic from 2010 to 2022. Patients were asked to report headache frequency, average headache severity and duration, and headache-related disability at both initial and follow-up visits.

According to results, follow-up visits within 30 to 90 days were less likely in Black patients (36.3%) compared with white patients (49.9%), as well as in Medicaid patients of both races (41.7% of white Medicaid patients vs. 53.8% using other insurance and 33.8% Black Medicaid patients vs. 42.4% using other insurance.)

Significant improvement in headache severity, frequency and duration was observed in patients who had follow-up visits between 30 and 90 days, despite racial or socioeconomic group.

“This highlights the need to examine strategies to mitigate disparities surrounding the referral to tertiary headache care and to treat with evidence-based medicine at all levels of care,” Saunders said.