Prevalence and burden of migraine in the United States: Data from the American Migraine Study II

Objective.-To describe the prevalence, sociodemographic profile, and the bu rden of migraine in the United States in 1999 and to compare results with t he original American Migraine Study, a 1989 population-based study employin g identical methods. Methods.-A validated, self-administered questionnaire was mailed to a sampl e of 20 000 households in the United States. Each household member with sev ere headache was asked to respond to questions about symptoms, frequency, a nd severity of headaches and about headache-related disability. Diagnostic criteria for migraine were based on those of the International Headache Soc iety. This report is restricted to individuals 12 years and older. Results-Of the 43527 age-eligible individuals, 29 727 responded to the ques tionnaire for a 68.3% response rate. The prevalence of migraine was 18.2% a mong females and 6.5% among males. Approximately 23% of households containe d at least one member suffering from migraine. Migraine prevalence was high er in whites than in blacks and was inversely related to household income. Prevalence increased from aged 12 years to about aged 40 years and declined thereafter in both sexes. Fifty-three percent of respondents reported that their severe headaches caused substantial impairment in activities or requ ired bed rest. Approximately 31% missed at least I day of work or school in the previous 3 months because of migraine; 51% reported that work or schoo l productivity was reduced by at least 50%. Conclusions.-Two methodologically identical national surveys in the United States conducted 10 years apart show that the prevalence and distribution o f migraine have remained stable over the last decade. Migraine-associated d isability remains substantial and pervasive. The number of migraineurs has increased from 23.6 million in 1989 to 27.9 million in 1999 commensurate wi th the growth of the population. Migraine is an important target for public health interventions because it is highly prevalent and disabling.