Associations of socioeconomic status with migraine and non-migraine headache

Background: Migraine has been linked with several measures of socioeconomic status (SES). However, results are inconsistent and data on the association between SES and non-migraine headache, migraine subtypes and migraine frequency are sparse. Methods: We conducted a cross-sectional study among 36,858 participants in the Women's Health Study. As proxy for SES, we calculated an SES index using annual household income and education. Migraine, migraine aura, and non-migraine headache were self-reported with good validation rates. Multinomial logistic regression models were used to evaluate the association between the SES index and the various headache forms. Results: Of the women participating in the study, 12,140 (32.9%) reported any history of headache, 6801 (18.4%) reported any history of migraine and 5339 (14.5%) reported non-migraine headache. Women with low SES had an increased risk for all headache forms. The multivariable-adjusted odds ratios (ORs; 95% CI) were 1.22 (1.10-1.36) for non-migraine headache, 1.40 (1.28-1.54) for any migraine, 1.44 (1.23-1.69) for migraine with aura, and 1.38 (1.21-1.58) for migraine without aura. Among active migraineurs, low SES was associated with an increased OR for >= weekly attack frequency (1.77, 1.26-2.49). Conclusions: In this large cohort of female health professionals, low SES was associated with an increased prevalence for all headache forms and an increased migraine attack frequency.