MARCH 10, 2025
Black and Hispanic children are far less frequently diagnosed with migraines than their white counterparts when they are seen by doctors for headaches in the ER while also receiving fewer tests and less intensive treatment, according to new research.
“Migraine is disabling and can significantly impact a young person’s quality of life, leading to problems in school performance, social activities and more,” said author Marissa Maliakal Anto, MD, MSc, of the University of
Black and Hispanic children are far less frequently diagnosed with migraines than their white counterparts when they are seen by doctors for headaches in the ER while also receiving fewer tests and less intensive treatment, according to new research.
“Migraine is disabling and can significantly impact a young person’s quality of life, leading to problems in school performance, social activities and more,” said author Marissa Maliakal Anto, MD, MSc, of the University of Pennsylvania, in Philadelphia. “Without a proper diagnosis, medications that can help reduce migraine may be delayed. Unfortunately, our study found racial and ethnic disparities in the diagnosis, testing and treatment of migraine.”
In the study, the investigators examined data on emergency department visits at 49 children’s hospitals over seven years, including 60,466 visits for headache by individuals aged 5 to 21 years. They also reviewed medical data to determine the diagnosis, testing and treatment for each participant.
The demographic makeup of the patient population was 25% Black, 26% Hispanic/Latino and 41% white.
The results show 28% Black participants and 28% of Hispanic participants were diagnosed with a migraine, compared with 46% of white participants.
After reviewing the data on testing, the investigators found 4% of Black, 4% of Hispanic and 9% of white participants had an MRI while in the ER. However, Black patients were 44% less likely than white participants and Hispanic patients were 46% less likely to receive an MRI after the investigators adjusted for factors such as age, sex and insurance type.
Black participants were also 37% and Hispanic participants 54% more likely to receive only oral medications without any intravenous medications compared with white patients.
Finally, Black patients were 20% less likely and Hispanic patients 35% less likely to be admitted to a hospital compared with white patients, but similar percentages of participants in all three groups received no medications.
“Headache is one of the most common symptoms at children’s hospital emergency departments,” Anto said. “More research is needed to understand how disparities in migraine diagnosis, testing and treatment affect children, teens and young people in the long term. Research is also needed to develop interventions to reduce these inequities.”
—Kenny Walter
