Migraine prevalence, socioeconomic status, and social causation
Migraine prevalence, socioeconomic status, and social causation
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DOI：
10.1212/wnl.0b013e3182a43b32
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发表时间：
2013-09-10
期刊：
影响因子：
9.9
通讯作者：
Lipton, Richard B.
中科院分区：
文献类型：
--
作者：
Stewart, Walter F.;Roy, Jason;Lipton, Richard B.
目的：确定偏头痛在低收入家庭中的高患病率是由高发病率还是低缓解率来解释。方法：我们使用了美国偏头痛患病率和预防研究的数据，该研究是美国全国132，674名女性的样本（应答率为64.3%）和124，665名12岁及以上男性（应答率为62.0%）。以前收集的数据偏头痛症状，发病年龄和人口统计学。以前验证的方法适用于美国偏头痛患病率和预防研究数据被用来模拟队列研究。在3个性别特异性HH收入组（≥ 60，000美元）中估计发病率和缓解率。采用卡方检验（chi（2）test）来确定HH收入组的发病率或缓解率是否不同，以解释HH收入组偏头痛患病率的差异。结果：女性（chi（2），p < 0.01）和男性（chi（2），p < 0.01）偏头痛患病率随着HH收入的减少而增加。种族和其他已知混杂因素不能解释差异。患病率的变化在很大程度上是由于女性（chi（2），p < 0.01）和男性（chi（2），p < 0.01）的低HH收入组的发病率较高。偏头痛缓解率没有不同的HH income.Conclusions：偏头痛的发病率较高，在较低的HH收入组是符合社会因果关系假说。一旦开始，偏头痛缓解与HH收入无关。发病和缓解可能有不同的病因。
Objective: To determine whether the known higher prevalence of migraine in lower household (HH) income groups is explained by a higher incidence rate or a lower remission rate.Methods: We used data from the American Migraine Prevalence and Prevention Study, a US national sample of 132,674 females (with a 64.3% response rate) and 124,665 males (with a 62.0% response rate) 12 years of age and older. Data were previously collected on migraine symptoms, onset age, and demographics. Previously validated methods applied to the American Migraine Prevalence and Prevention Study data were used to simulate a cohort study. Incidence and remission rates were estimated within 3 sex-specific HH income groups (=$60,000). The chi(2) test was used to determine whether the incidence or remission rates differed by HH income group as an explanation for differences in migraine prevalence by HH income.Results: Migraine prevalence increased as HH income decreased for females (chi(2), p < 0.01) and males (chi(2), p < 0.01). Differences were not explained by race and other known confounders. Variation in prevalence was explained, in large part, by a higher incidence rate in the lower HH income groups for both females (chi(2), p < 0.01) and males (chi(2), p < 0.01). Migraine remission rates did not differ by HH income.Conclusions: The higher incidence of migraine in lower HH income groups is compatible with the social causation hypothesis. Once initiated, migraine remission is independent of HH income. Onset and remission may have etiologically distinct causes.