Prevalence and Cost Of Headache
Prevalence and Cost of Headache
As no major studies have been undertaken in Australia we must rely on overseas studies, particularly those carried out in the United States, for information about prevalence and cost.
Based on the studies summarised below, we can expect the following statistics to apply to Australia:
Extracts from the studies on which we base this information are included below.
1. World Health Organisation Report
Headache Disorders and Public Health, Education and Management Implications
Headache is a symptom of a range of neurobiological disorders, including some of the most common and ubiquitous. Adults aged 20 – 50 years are the most likely sufferers but children and adolescents are affected too. The term ‘headache disorder’ encompasses a number of conditions that vary in severity, incidence and duration. As a consequence establishing their overall prevalence has been difficult. There is a lack of worldwide studies on the different headache sub-types. Those carried out have employed different methodologies although headache definitions were standardised by the International Headache Society in 1988.
What is undisputed is that migraine and tension-type headache are the most prevalent headache disorders and, both with disabling potential, they have the greatest impact on public health.
Migraine is the more thoroughly investigated, and better understood. Onset of migraine is from childhood onwards but most commonly in the 20s and 30s and relatively infrequently after the age of 40 years; therefore, prevalence increases from the first to fourth decades and thereafter declines. Migraine may nevertheless be a significant health issue among children.
Overall, migraine has a variable prevalence worldwide. In European and American studies the one-year period prevalence of migraine in adults is estimated at 10-15%.
The frequency of migraine attacks is highly variable, from 1/year in some to more than 1/week in as many as 25% of sufferers. The average may be as high as 21 episodes per sufferer per year.
Tension-type headache is the most widespread of headache disorders. Onset is often in the teenage years and prevalence peaks in the fourth decade and then declines. Overall, one-year prevalence may exceed 60% although it is apparently lower in some countries. A large part of the population have mild and infrequent tension-type headache (once monthly or less), with 20-30% experiencing headache episodes more often. Tension-type headache is also more common in women, in a ratio of 1.5:1.
These common neurological complaints impose a significant health burden, with nearly all migraine sufferers and 60% of those with tension-type headache experiencing reductions in social activities and work capacity. Despite this, both the public and the majority of healthcare professionals tend to perceive headache as a minor or trivial complaint. As a result, the physical, emotional, and economic burdens of headache are poorly acknowledged in comparison with those of other, less prevalent, neurological disorders.
2. Studies Carried Out in the United States
Findings from three major studies involve leading epidemiologist Dr Richard Lipton are summarised below. Dr Lipton is Professor of Neurology, Epidemiology and Social Medicine at Albert Einstein College, New York and has published over 300 original articles and reviews in the fields of headache, neuroepidemiology and health services research.
Prevalence and Burden of Migraine in the United States: Data from the American Migraine Study II- R.B Lipton MD, W.F Stewart MPH PhD, S. Diamond MD, M.L Diamond MD and M. Reed PhD, reported in Headache 2001;41:646-657.
Migraine Diagnosis and Treatment: Results from the American Migraine Study II- R.B Lipton MD, W.F Stewart MPH PhD, S. Diamond MD, M.L Diamond MD and M. Reed PhD, reported in Headache August 2001; 41:638-645.
Disability and economic costs of migraine in the United States: A population-based approach – X. Hu, L. Markson, R.B Lipton et al 1999 Arch.Intern. Med. 159:813-818
3. Studies Carried Out in Australia
Prevalence of headache and migraine in an Australian city- J. Heywood, T. Colgan, and C. Coffey- Journal of Clinical Neuroscience (1998) 5(4), 485.
This Melbourne study, involving interviewing 1717 individuals, aged 12 and over, from 773 households, found that:
Prevalence and vascular associations with migraine in older Australians – P. Mitchell, J.J Wang, J. Currie, R.G Cumming and W. Smith – ANZ Journal of Medicine Vol 28 No 5 October 1998
This 1992- 1994 Blue Mountains NSW study, involving 3654 residents of two postcode areas aged 49 or older, found that:
The Prevalence and Costs of Migraine in Australia – T.G Parry, School of Economics, University of New South Wales 1990-91.
This study summarised estimates of the major direct and indirect costs of migraine in Australia:
Total Costs of Migraine in Australia, 1989 – 90
|Medical services including outpatient|
|Other health professionals|
Indirect costs *
|Productivity losses at work|
* Total productivity losses from days away from work plus productivity losses while at work subject to a migraine episode.
1 Wolff’s Headache And Other Head Pain 7th ed – S.D Silberstein, R.B Lipton, D.J Dalession 2001
Prepared by Louise Alexander, PhC, Grad Dip Comm Mngt, Former National Director of the Brain Foundation. Reviewed by Professor James Lance, AO, CBE, MD, Hon DSc, FRCP, FRACP, FAA, Consulting Neurologist, and author, “Migraine and Other Headaches”