The primary objective is to investigate the undertreatment of migraine pain for African American patients and females using injectable vs oral medications as measurement of medication potency to determine bias. 

Each year, migraines affect over 1 billion people and are the second leading cause of disability worldwide. Of those affected, migraines are present in women nearly 3 times more than men, leading to the stigma of migraines being “a woman’s complaint”. This sexual disparity is compounded by racial inequality. Studies have found that African American patients are often undertreated for pain. However, there is a gap in the literature about how this disparity translates to migraine treatment, specifically considering patient gender. 

This was a retrospective database analysis consisting of patients aged 12-25 who presented to the Emergency Department (ED) for migraine treatment within the years 2015 and 2016.  Among the dataset of 1000 randomly de-identified patients, 729 patients presented to the ED only once within the time frame. We conducted a logistic regression model to determine the statistical significance of the correlation between the potency of medication prescribed with race and gender. 

African American patients were 37% less likely to receive intravenous medication compared to Caucasian patients (Odds ratio, 0.63; 95% CI, 0.45-0.88; P=0.01). Furthermore, female African American patients were 46% less likely to receive intravenous medication compared to their female Caucasian counterparts (Odds ratio, 0.54; 95% CI, 0.37-0.78; P=0.001). There was no statistically significant difference in potency of treatments between African American males and Caucasian males. 

Significant racial disparities exist in the administration of injectable migraine medication, with African American patients, particularly female African American patients, being less likely to receive potent treatment compared to their Caucasian counterparts. By establishing where racial disparities exist in the health setting, we can work towards closing the gap and moving towards equity.