Minority Children Less Likely to Be Diagnosed With Migraine in Emergency Department

WEDNESDAY, Feb. 5, 2025 (HealthDay News) — Compared with non-Hispanic White (NHW) children, non-Hispanic Black (NHB) and Hispanic/Latino (HL) children with a headache diagnosis in the emergency department have lower rates of migraine diagnosis, undergo less testing, and receive less intensive treatment, according to a study published online Feb. 5 in Neurology.

Danielle Kellier, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues examined racial and ethnic disparities in the diagnosis, testing, and treatment of pediatric patients (age 5 to 21 years) presenting to the emergency department with headache in a cross-sectional study of visits from 49 children”s hospitals between 2016 and 2022.

Of the 160,466 eligible visits, 41.0, 24.8, and 26.0 percent were by NHW, NHB, and HL children, respectively. The researchers found that NHW children were more often diagnosed with migraine compared with NHB and HL children (45.5 percent versus 28.2 and 28.3 percent, respectively). Compared with NHW children, NHB and HL children received less testing, including brain magnetic resonance imaging scans (adjusted odds ratios, 0.56 and 0.54, respectively). The proportion of visits without administration of headache-related medications did not differ between the groups (23.3, 24.6, and 23.4 percent for NHW, NHB, and HLs, respectively). Compared with NHWs, NHB and HL children were more likely to receive only oral medications (adjusted odds ratios, 1.37 and 1.54, respectively) and less likely to be admitted as inpatients (adjusted odds ratios, 0.80 and 0.65, respectively).

“Further research is necessary both to understand how disparities in headache management affect outcomes and to develop interventions to reduce inequity in the management of headache, one of the most common concerns seen in the pediatric emergency department,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

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