Migraine is a neurological disorder characterized by recurrent moderate to severe headaches, lasting from several hours to several days. Unlike common headaches, migraines typically present with throbbing pain, often on one side of the head, and can be accompanied by symptoms such as nausea, vomiting, and heightened sensitivity to light and sound. Understanding migraine prevalence is important for recognizing its scope and impact on individuals and public health worldwide.
Global and Regional Occurrence
In 2019, the estimated global prevalence of migraine reached 1.1 billion cases, an increase from 721.9 million cases in 1990. This translates to approximately 14,246.55 cases per 100,000 population in 2021. Headache disorders, including migraines, collectively affect about 40% of the global population, or 3.1 billion people.
The occurrence of migraines shows variations across different regions. In 2019, the highest age-standardized point prevalence rates were observed in countries like Belgium, with approximately 22,400 cases per 100,000, and Italy, at about 20,337.7 cases per 100,000. Conversely, regions such as Ethiopia and Djibouti reported lower rates, with roughly 8,277 and 8,915.3 cases per 100,000, respectively. These regional differences can be influenced by various factors, including diagnostic practices, public awareness, and environmental conditions.
Prevalence Across Demographics
Migraine prevalence exhibits distinct patterns across different demographic groups, with noticeable differences based on gender, age, socioeconomic status, and ethnicity. These variations provide insights into how the condition impacts diverse populations.
Women are significantly more likely to experience migraines than men. In the United States, women are approximately three times more prone to migraines, with up to 17% of women experiencing attacks annually compared to 6% of men. This disparity is often linked to hormonal fluctuations, particularly during reproductive years, where changes in estrogen levels before or during menstruation, during pregnancy, or in perimenopause can influence migraine frequency and severity.
Migraine prevalence also changes with age. The condition typically begins around puberty and is most common in individuals aged 35 to 45 years. In both women and men, migraine prevalence generally increases up to around age 40 before declining in older age groups. For example, in 2021, the percentage of adults bothered by migraine was highest in those aged 18-44 years (7.4% for women, 2.5% for men) and lowest in those aged 65 years and older (3.1% for women, 1.5% for men).
Socioeconomic status (SES) also correlates with migraine prevalence. Studies indicate that individuals in lower household income groups tend to have a higher prevalence of migraines for both women and men. This increased prevalence in lower SES groups is largely attributed to a higher incidence rate of migraines rather than differences in remission rates.
Regarding ethnicity and race, a 2015 review of studies in the U.S. found that American Indians or Alaska Natives had the highest percentage of migraines or severe headaches, at 18.4%, while Asian Americans had the lowest, at 11.3%. Other groups, such as white Americans (15.5%), Hispanic Americans (14.5%), and Black Americans (14.45%), showed varying prevalence rates. It is also noted that chronic migraines, defined as 15 or more headache days per month, occur most frequently in Hispanic women and least often in white men.
Trends in Migraine Prevalence
The global prevalence of migraine has shown an increasing trend over the past few decades. The number of prevalent cases rose from 732.56 million in 1990 to 1.16 billion in 2021, an approximate increase of 58.15%.
Despite this increase in the total number of cases, recent systematic reviews suggest that the age-standardized prevalence rate of migraine has remained relatively stable over time, ranging from 11.7% to 14.7% in the U.S. between 1989 and 2018. However, the disability associated with migraine has nearly doubled during this period, indicating a growing burden for individuals living with the condition. This discrepancy between stable prevalence and rising disability may be influenced by factors such as improved diagnostic methods, increased awareness of the condition, or changes in lifestyle that affect migraine severity.
Understanding the Public Health Burden
Migraine prevalence highlights a substantial public health burden on individuals and society. Migraines are a leading cause of disability worldwide, ranking as the third greatest contributor to disability-adjusted life years (DALYs) among 37 neurological conditions in 2021.
The economic impact of migraines is considerable. In the United States, the annual direct healthcare costs for individuals with migraine are significantly higher than for those without, with estimates around $22,364 per person compared to $15,697. Prescription drugs account for nearly half of these healthcare costs. Beyond direct medical expenses, migraines also lead to substantial indirect costs, primarily from lost productivity due to absenteeism (missed workdays) and presenteeism (reduced productivity while at work). The total indirect cost associated with migraine in the U.S. has been estimated at approximately $19.3 billion, with 81% attributed to absenteeism.
Migraines significantly diminish individuals’ quality of life. The severe pain, coupled with symptoms like nausea and sensitivity to light and sound, often makes it difficult or impossible for affected individuals to perform daily activities, including work and social engagements. This profound impact can affect careers, financial stability, relationships, and mental well-being.
The high prevalence of migraines also strains healthcare resources. Individuals with migraines utilize more healthcare services, including emergency department visits. This increased demand underscores the need for improved migraine management strategies, better access to care, and continued research to develop more effective treatments. Recognizing the widespread impact of migraines highlights the need for public awareness and sustained research investment.