Research News

Disparities Likely Exist in Headache Treatment for Children

Low income youths may be at heightened risk for headache, and minority children with headaches may receive less care by neurologists. These are the findings from a study in the Journal of Childhood Neurology that examined racial and ethnic differences in receiving a headache diagnosis during pediatric health care visits.

“Racial disparities have been repeatedly documented for a wide variety of neurological conditions in adult and pediatric patients,” said Ann Pakalnis, MD, director of the Headache Clinic at Nationwide Children’s Hospital and one of the study authors.  “However, surprisingly little research has investigated the possible racial disparities in diagnosis and treatment of headaches, despite the fact that headaches are among the most common neurological conditions in both adulthood and childhood.”

Using data from two nationally representative databases, faculty from the Center for Biobehavioral Health at The Research Institute at Nationwide Children’s Hospital and the Section of Neurology investigated the number of children age 3 to 17 who were diagnosed with a headache during a nine-year period.

“We found some noteworthy disparities in the diagnosis and treatment of headache that are likely generalizable for children throughout the United States,” said Jack Stevens, PhD, principal investigator in the Center for Biobehavioral Health and one of the study authors.

First, visits by children with Medicaid were more likely to involve a headache diagnosis than visits by children covered by private insurance.  Second, visits by Caucasian American children, African American children and children of other races were equally as likely to involve a headache diagnosis. However, visits by children in the latter two groups were less likely than visits by Caucasian children to involve a headache diagnosis by a neurologist.  Primary care clinicians appeared particularly likely to provide headache care for minority children. Finally, fewer than 40 percent of the documented headache visits involved a prescription of an evidence-based medication.

“Further research is needed to clarify explanations for these disparities and to design interventions to eliminate their existence for pediatric headache,” said Dr. Stevens.

Stevens J, Harman J, Pakalnis A, Lo W, Prescod J. Sociodemographic Differences in Diagnosis and Treatment of Pediatric Headache. J Child Neurol. 2009 Oct 6. [Epub ahead of print]

Disclosure:  Dr. Stevens is a former shareholder in Wyeth. 

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