Is There a Link Between Migraines and My Income?

The Start, The Stop, The Money

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The burden of being a migraine sufferer is often compounded by its effects on your work life. Whether you have to take medical leave, miss multiple days of work a month, or find yourself present, but not very functional at work, than your stress level is likely pretty high. Of course, this stress can then precipitate or worsen headaches, creating a vicious cycle. Do you believe your migraines affect your performance at work, therefore impacting your income ability?

Or does your work itself create stress that likely triggers your migraines? There are lots of ways to look at this, and scientists are currently exploring the complex relationship between migraines and one’s socioeconomic status or income level. Let’s take a look at one recent study that analyzes the link between migraines and income.


A study published in Neurology examined over 162,000 people (64% females, 62% males) aged 12 and older. The subjects completed the migraine disability assessment questionnaire (MIDAS) as well as a series of questions, regarding the age at which they had their first severe headache, symptoms that support their headache diagnosis, and their household income.

Low income was defined as less than $22,500 per year for the household and high income was defined as $60,000 per year or more.


The results showed that there were more migraineurs in the lower income group than the higher income group.

For instance, for women age 35-44, 23 percent of those from high-income households had migraine, compared to 29 percent of those with middle income and 39 percent of those with low income. For men in that age range, 5 percent in high-income households had migraine, compared to 8 percent in middle income and 15 percent in low income.

Researchers of the study noted that the results were the same after adjusting for other factors such as gender, age and race.

The study also revealed that migraineurs in the lower-income group were more likely to have severe pain and disability from their headaches than migraineurs in the higher-income group. Finally and most notably, the study showed that the remission rate or “stopping” of migraines was no different between the lower and higher income groups.

What Does This Mean?

The fact that the "stopping" of migraines or remission rate was no different between the two income groups means that the start of migraines is more likely if you have a lower income, but, the stop or remission of your migraines is not affected by your income. In essence, this study questions the prior theory, called the social selection hypothesis, that migraines cause individuals to move to a low income bracket due to poor functioning and missed days of work. Instead, being in a low income bracket may make you more prone to migraines based on the likelihood of other stressful factors in your life, according to these study results. This hypothesis is known as the social causation hypothesis, which means that a lower socioeconomic status is linked to stress and other migraine mediators that increase its incidence and/or duration (only incidence in this study).

Take Home Points

• Remember — and this is key — that a link or association does not mean that one causes the other. The big picture here is that the onset, but not cessation of migraines, may be related to one’s income bracket, suggesting that certain factors within a lower socioeconomic status may contribute to the start of migraines.

• Studies are not perfect and have pitfalls and limitations. One downside to this study is that it excluded individuals with chronic migraine.

• The social causation hypothesis is supported in this particular study and provides an avenue for further research into the particular migraine triggers and/or stresses involved in being in a lower income bracket.

• As always, be proactive in your healthcare. Evaluate your current social and economic situation or lifestyle to see if this has implications for your migraines. Consider discussing this with your spouse, doctor or friend.


Stewart WF, Lipton RB, Celentano DD, Reed ML. Prevalence of migraine headache in the United States: relation to age, income, race, and other sociodemographic factors. JAMA 1992;267:64–69.

Stewart WF, Roy J, Lipton RB. Migraine prevalence, socioeconomic status, and social causation. Neurology. Published online before print August 29, 2013.

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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