Headache is One of the Top Ten Most Disabling Health Problems Says New Study
Almost 50 per cent of the world’s population are affected by headache, making it one of the top ten most disabling global health problems, concludes a study in March’s issue of Cephalalgia.
An international research group, chaired by Professor Lars Jacob Stovner of the Norwegian University of Science and Technology, collated all studies on headache prevalence and its consequences published up to 2006. The review shows that headache is a truly global complaint, with a major impact on both quality of life and the economy.
According to the review, one in nine (11 per cent) of the world’s adult population have migraine. Ordinary headache, correctly called tension-type headache, afflicts almost half (42 per cent) of all adults. While migraine tends to be more burdensome for the individual, the review authors claim that, because of the numbers of people affected, tension-type headache has an even greater impact on society as a whole.
This finding is confirmed by studies from developed countries that show more work days are lost each year from tension-type headache than from migraine.
The review also reveals some interesting differences in headache prevalence across the world. For example, both migraine and tension-type headache seem to be less prevalent in Africa, although the authors call for more studies in this region as the evidence there is limited.
For most individual people, headache is a minor ailment that is coped with quite easily, but the authors warn this leads to complacency. Professor Stovner explains: “We often hear that headache is a trivial disorder. For the many with a serious headache problem this attitude can be very disheartening.
“A most disquieting finding of the study is that 3% of the world’s adult population suffer from chronic daily headache – that is, headache on more than every other day for at least several months. This group of more than 100 million people worldwide probably carry the greatest headache burden, and possibly also a stigma since their disorder is not generally acknowledged as a proper disease.
Dr. Timothy Steiner at Imperial College, London, UK, co-author of the article and chairman of Lifting The Burden: The Global Campaign to Reduce the Burden of Headache Worldwide, adds: “This study is important in helping us to understand the scale of the headache burden everywhere in the world. It shows, starkly, why we need a Global Campaign, and it strongly supports the messages the Campaign takes to governments and others responsible for health-service policy and delivery. There are still parts of the world, such as China, India and Africa, where the Campaign needs to undertake more research to improve our knowledge of how headache affects both people and society, but elsewhere the evidence is crystal clear.
“In many cases, headache disorders such as migraine and tension-type headache can be simply and effectively treated, but first they must be recognised as needing treatment and doctors and other health-care providers trained in their diagnosis and management. The public need to know that treatments are available and governments must understand the benefits – in public health and in better productivity – of making these treatments available. The Global Campaign, with the committed support of the World Health Organization, has precisely these objectives.”
- A total of 107 publications were analysed: 48 from Europe, 20 from Asia, 14 from North America, 13 from Central/South America, eight from Africa and four from Australia/Oceania. Table 1 lists the global prevalences of current (within the last year) and lifetime experience of headache.
- These new figures bring headache disorders into the top ten of the World Health Organization’s ranking of causes of disability for both men and women. In women alone, headache is almost certainly among the top five most disabling conditions.
- The number of people affected by headache varies around the globe: about 50% of people in Asia, Australia, Europe and North America, but possibly only 20% in Africa.
- The individual headache burden during an average migraine attack was more than twice as high as the burden during a tension-type headache. However, when the frequency of each type of headache is considered (headache days per person in the population), tension-type headache (including chronic daily headache) contributed 58% of the total burden of headache and migraine 42%.
Stovner LJ, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher AI et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia 2007;27:193-210.
What the WHA thinks
- This is a milestone study, giving us a greater understanding of how many people are affected by headache around the globe.
- Although more work is needed to determine the prevalence of headache in parts of the world where there are few data available, it is clear that headache exerts an enormous impact on global health.
- The finding that headache is among the top ten most disabling conditions, and probably among the top five for women, makes clear to all that this is a serious problem demanding treatment as such.