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Association between family income to poverty ratio and severe headache/migraine in the American adults: data from NHANES 1999–2004

Lingling Sun,Rongjiang Zhao,Xuemei You,Junpeng Meng,Lin Meng,Haili Di

Published 2024 in Frontiers in Neurology

ABSTRACT

Background The relationship between family income to poverty ratio (PIR) and severe headache/migraine remains unclear. Methods Data for this cross-sectional study were obtained from NHANES 1999–2004. PIR was the exposure variable, and severe headache/migraine was the dependent variable. We performed univariate analyses of severe headache/migraine, PIR, and other covariates. The association between PIR and severe headache/migraine was tested using multiple regression models. Furthermore, interaction tests and stratified analyses assessed the relationship between PIR and severe headache/migraine across subgroups. Results There were a total of 8,800 participants: 4,833 (54.92%) males and 3,967 (45.08%) females, 1,714 (19.48%) with severe headache/migraine and 7,086 (80.52%) without severe headache/migraine. After adjustment for all variables, PIR negatively correlated with severe headache/migraine OR = 0.86 95% CI (0.83, 0.90) p < 0.0001. The variable PIR was categorized as the low-income (PIR < 1), the middle-income (PIR1-4), and the high-income (PIR > 4). Notably, there was a significant difference in trend for the high-income group (PIR > 4) compared to the control low-income group (PIR < 1) (all P for interaction<0.05). Dose–response correlations were also analyzed using smoothed curve fitting, revealing a negative correlation between PIR and severe headache/migraine (p < 0.0001). Subgroup analysis results indicated that the negative association between PIR and severe headache/migraine was more pronounced in the following populations: males (OR = 0.84 95% CI (0.79, 0.90), <60 years old [Age < 45 group OR = 0.81 95% CI (0.76, 0.85)], Age 45–60 group OR = 0.86 95% CI (0.79, 0.93), and those with education levels ≥high school [High School OR = 0.87 95% CI (0.81, 0.95), >High School OR = 0.82 95% CI (0.78, 0.87)]. Conclusion There is a negative correlation between PIR and the incidence of severe headaches/ migraine in Americans aged 20 years or older. This study has implications for the comprehensive management of patients with severe headache/migraine.

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