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Abstract Details

Population-based Study of Health Disparities in Migraine Diagnosis and Treatment in American Indian Arizona Medicaid Recipients
Headache
P3 - Poster Session 3 (11:45 AM-12:45 PM)
12-001

Investigate health disparities by assessing the likelihood of receiving a migraine diagnosis and migraine-specific treatment among American Indian (AI) Arizona Medicaid (AHCCCS) recipients.

AI and Alaskan Natives have the highest prevalence of migraine and severe headaches compared to other racial groups. Nationally, AI represent 1.1% of the population. In Arizona, they represent 4.5% and account for 8% of AHCCCS recipients.
AHCCCS members aged 3 and older, who self-identified as AI, with an enrollment gap of no more than 45-days per year between 2018 and 2020 were included. Demographic characteristics, comorbid diagnoses, and social risk factors (based on ICD Z codes) were compared using ANOVA F-tests or Chi-squared tests, with multivariate logistic regression used to investigate associations.
Identifying as AI rather than White reduced the likelihood of receiving a migraine diagnosis (Pediatric 0.65 (95% CI: 0.59, 0.71) p<0.001; Adult 0.6 (95% CI:  0.58, 0.62) p<0.001) and migraine specific treatments (Pediatric 0.76 (95% CI: 0.59, 0.99) p=0.042; Adult 0.5 (95% CI: 0.46, 0.55) p<0.001) . Residing in an urban setting increased the likelihood of a migraine diagnosis (Pediatric 1.33 (95% CI: 1.08, 1.64) p=0.007; Adult 1.15 (95% CI: 1.07, 1.24) p<0.001). Urban residence did not affect the likelihood of pediatric AI receiving a migraine specific treatment but increased the likelihood for adult AI (1.71 (95% CI: 1.41, 2.07) p<0.001). Negative social factors decreased the likelihood of adult AI receiving a diagnosis of migraine (Ex. housing, basic amenity and environment factor 0.61 (95% CI: 0.53,0.71) p<0.001).
AI were less likely to receive a migraine diagnosis and migraine-specific treatment. Interventions that address migraine healthcare disparities amongst AI are needed.
Authors/Disclosures
Jessalyn Shen, MD
PRESENTER
Dr. Shen has nothing to disclose.
Nan Zhang Nan Zhang has nothing to disclose.
Michael Stitzer, MD (Winslow Indian Health Care Center) Dr. Stitzer has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生.
Todd J. Schwedt, MD, FAAN (Mayo Clinic) Dr. Schwedt has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Schwedt has received personal compensation in the range of $0-$499 for serving as a Consultant for Amgen. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scilex. Dr. Schwedt has stock in Aural Analytics. Dr. Schwedt has stock in Nocira. Dr. Schwedt has stock in Allevalux. The institution of Dr. Schwedt has received research support from National Institutes of Health. The institution of Dr. Schwedt has received research support from United States Department of Defense. The institution of Dr. Schwedt has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Schwedt has received research support from SPARK Neuro. The institution of Dr. Schwedt has received research support from Henry Jackson Foundation. The institution of Dr. Schwedt has received research support from Pfizer. The institution of Dr. Schwedt has received research support from National Headache Foundation. The institution of Dr. Schwedt has received research support from American Heart Association. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received publishing royalties from a publication relating to health care.
Juliana VanderPluym, MD (Mayo Clinic) Dr. VanderPluym has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Neurology and Neuroscience Reports. The institution of Dr. VanderPluym has received research support from Amgen.