Addressing Health Disparities in Headache and Migraine Care

By: Cheryl McJoy, Katy Oakley, and Fabiola Palomo

 

Headache and migraine disorders disproportionately impact marginalized communities. If you’ve ever sat in a doctor’s office, clutching your head in pain, only to be dismissed or told it’s “just stress,” you’re not imagining it. For many African American and Latinx patients, this is an all-too-common experience. The pain is real, but care is often lacking, and the staff is unsympathetic to your needs.

A migraine isn’t just a headache. It disrupts daily life, interferes with work and family responsibilities, and takes a significant emotional and physical toll. When compounded by disparities in healthcare, where voices go unheard and pain is overlooked, it can be especially isolating.

The truth is these inequities are well-documented. Research shows that African American and Latinx patients are significantly less likely to be diagnosed with migraine than white patients. Black patients are also far less likely to receive diagnostic imaging in emergency departments as well utilize healthcare settings for migraine, receive a headache diagnosis, or be prescribed migraine medication.[1] Following a traumatic brain injury, Latinx and African American patients often receive less intensive rehabilitation support.[2]

Many patients of color face challenges in accessing proper migraine treatment, especially when insurance denies necessary medications. Without reliable care, many turn to emergency departments for relief, often as a last resort. Additionally, fear of discrimination or poor treatment leads some, particularly within the Latinx community, to avoid seeking medical care altogether, further widening the gap in finding effective treatment and support.[3]

These aren’t just statistics; they represent real people navigating a system that hasn’t always worked in their favor. Despite these challenges, there is hope. With knowledge, self-advocacy, and the right support, it’s possible to take control of your healing journey. The path may not be easy, but it is navigable, and no one should have to walk it alone.

Read the following tools, resources, and guidance ahead to help anyone move toward more equitable care and a better quality of life.

What can you do to be heard? Here are some self-advocacy tips: 

Know Your Body, Know Your Triggers. The first step is understanding your own unique experience with headache or migraine. What are your specific symptoms? When do the attacks tend to occur? Keeping a detailed log, whether through voice notes, an AI assistant, or a traditional migraine journal, can help you identify personal triggers and patterns.

Don’t just tell the provider you have a “headache” – be specific. Describe the location and type of pain, any accompanying nausea or sensitivity to light, and how it compares to your normal baseline. The more detailed you can be, the harder it is for a provider to dismiss your experience.

Stand Up for Yourself. It’s crucial that you don’t simply accept whatever a provider tells you, even if they have impressive credentials. If you feel you’re not being heard or taken seriously, push back. Calmly insist that your pain is real and unacceptable. You can request better care if needed.

Request Documentation of Dismissed Concerns – If your provider downplays your symptoms or dismisses your requests for tests or treatment options, ask them to document in your medical records that you raised the concern and that they chose not to take action. This creates a paper trail that can be useful for second opinions, future care, or advocating for yourself if symptoms worsen.

Keep notes on the date, time, and details of any unsatisfactory interactions. You can file complaints with patient advocates if a provider is consistently dismissive or providing substandard care. If necessary, you can also file a report with the medical board. Don’t be afraid to seek a second opinion or even change providers entirely if needed.

Explore Alternative Treatments. Many healthcare providers might not be well-versed in the full range of migraine and headache treatments. Don’t be afraid to ask about options like nerve stimulators, acupuncture, supplements, or non-pharmaceutical approaches. These can be especially helpful for patients who are sensitive to side effects or want to avoid taking daily pills. Again, be prepared to advocate for the treatments that work best for you, even if they aren’t a provider’s first recommendation. Your health and quality of life should be the top priority. You know your body best.

Navigating the VA System. For veterans, the challenges of accessing proper headache and migraine care can be even more daunting. Female vets of color can face dismissive attitudes by VA staff. It’s critical to be aware of the VA’s Headache Centers of Excellence, specialized clinics that provide comprehensive care. However, getting a referral from your primary care provider can be difficult, as they may not consider your condition severe enough. Persistence is key – keep pushing until you get the care you need and deserve.

Ultimately, the medical system is not designed to cater to each patient’s unique needs and experiences. By taking an active role in your care, learning to speak the language of your providers, and refusing to accept substandard treatment, you can overcome the barriers and get the relief you’ve been seeking.

Your voice and your health matter. Be smart, be strategic, and advocate for yourself.

[1] Rizzoli, P. (2022, February 15). Health disparities and headache treatment – Harvard Health. Harvard Health. https://www.health.harvard.edu/blog/health-disparities-and-headache-treatment-202202152685?fbclid=IwY2xjawITC0ZleHRuA2FlbQIxMAABHa38UjWzIcr05kr3L1cM98sYb8FoEgb5Np59yXU-daFNFW-iCDhKhrc8-g_aem_2Ce23VeL6g6K_sa09oEDag

[2] Meagher, A. D., Beadles, C. A., Doorey, J., & Charles, A. G. (2015). Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury. Journal of neurosurgery, 122(3), 595–601. https://doi.org/10.3171/2014.10.JNS14187

[3] Findling, M. G., Bleich, S. N., Casey, L. S., Blendon, R. J., Benson, J. M., Sayde, J. M., & Miller, C. (2019). Discrimination in the United States: Experiences of Latinos. Health services research, 54 Suppl 2 (Suppl 2), 1409–1418. https://doi.org/10.1111/1475-6773.13216