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A Review of Underserved and Vulnerable Populations in Headache Medicine in the United States: Challenges and Opportunities

  • Hot Topics in Pain and Headache (N Rosen, Section Editor)
  • Published:
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Abstract

Purpose of Review

This review will briefly summarize recent literature published on headache disparities in underserved and vulnerable populations. It will also report the personal observations of headache medicine providers working with underserved and vulnerable populations in the USA, specifically in an urban practice dedicated to patients in a safety net program and a rural practice dedicated to Native American patients.

Recent Findings

Headache disorders are recognized as one of the most prevalent neurological conditions. People with headache and migraine encounter several barriers to obtaining appropriate care, which are magnified in vulnerable and underserved populations. Research has shown disparities in headache and migraine diagnosis, prevalence rates, treatment, and outcomes based on race, socioeconomic status, and geography.

Summary

Continued research regarding disparities in headache medicine is required. Strategies to address the identified challenges, including structural competence and the underrepresented in medicine pipeline, are reviewed.

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Author information

Authors and Affiliations

  1. Mayo Clinic Arizona, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA

    Juliana H. VanderPluym

  2. Michigan State University College of Human Medicine, East Lansing, MI, USA

    Larry Charleston IV

  3. Winslow Indian Health Care Center, Winslow, AZ, USA

    Michael E. Stitzer

  4. David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Charles C. Flippen II

  5. Albert Einstein College of Medicine, Montefiore Headache Center, Bronx, NY, USA

    Cynthia E. Armand

  6. UT Southwestern Medical Center, Dallas, TX, USA

    Jessica Kiarashi

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Correspondence to Juliana H. VanderPluym.

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Conflict of Interest

Juliana H. VanderPluym: received research grants from Amgen. She is a Section Editor of Current Neurology and Neuroscience Reports. Larry Charleston IV: received personal compensation for serving as a consultant for Allergan/AbbVie, Alder/Lundbeck, Biohaven, Satsuma, and Teva; is on the advisory panel for Ctrl M Health (stock); received grant support from the Disparities in Headache Advisory Council; served as an Expert Witness for Vaccine Injury Compensation Program. He is a non-compensated associate editor for Headache: The Journal of Head and Face Pain and serves as a non-compensated Board Member-at-Large for the Alliance for Headache Disorders Advocacy. Michael E. Stitzer declares no conflict of interest. Charles C. Flippen declares no conflict of interest. Cynthia E. Armand: received personal compensation as a consultant for Biohaven, Impel Regional, and Teva. She is web editor for JAMA Neurology. She is a non-compensated Board Member for The Society of Haitian Neuroscientists. Jessica Kiarashi declares no conflict of interest.

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VanderPluym, J.H., Charleston, L., Stitzer, M.E. et al. A Review of Underserved and Vulnerable Populations in Headache Medicine in the United States: Challenges and Opportunities. Curr Pain Headache Rep 26, 415–422 (2022). https://doi.org/10.1007/s11916-022-01042-w

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