This study investigated the relationship between headache frequency, perceived discrimination (lifetime and in a medical setting), and migraine-specific quality of life among an African American (AA) sample.

Self-identified AA with an ICD-10 diagnosis of migraine, seen at a tertiary headache center within the last 12 months, were recruited via telephone and email to participate in a one-time online survey. Data collection included Item A of the Migraine Disability Assessment (MIDAS-A), the Migraine-Specific Quality of Life Questionnaire (MSQ) v2.1, the Brief Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV), and the Discrimination in Medical Settings (DMS) Scale. Pearson correlations evaluated bivariate relationships among variables.

Ninety-one individuals (94.5% female, 5.5% male), all identifying as Black and/or AA (72.5% Non-Hispanic, 27.5% Hispanic), ages 18 to 78 years (M = 38.49, SD = 12.58) participated. Higher levels of discrimination in medical settings were associated with increased headache days (MIDAS-A: r = 0.26, p < .05), while lifetime discrimination showed a weak non-significant association (r = 0.07, p > .05). Significant negative associations were observed between the PEDQ-CV and MSQ subscales: Role Function Restrictive (r = -.27, p < .05) and Emotional Function (r = -.23, p < .05). Meanwhile, DMS scores negatively associated with all MSQ subscales Role Function Restrictive (r = -0.28, p < .01), Role Function Prevention (r = -.23, p < .05), and Emotional Function (r = -0.23, p < .05).

Discrimination, particularly in medical settings, is associated with increased headache frequency and decreased migraine-specific quality of life in AA with migraine. Addressing discrimination may help to build trust, encourage migraine care-seeking, and reduce disparities in AA patients with migraine.