Headaches are the most common health disorders across the world, yet they remain neglected and under-treated, according to a United Nations study released today, which calls for greater investment in health care to treat the problem effectively through better services and awareness.
In its Atlas of Headache Disorders and Resources in the World 2011, the UN World Health Organization (WHO) shows that headache disorders, including migraine and tension-type headaches, affected half to three quarters of adults between the ages of 18 and 65 last year.
Only a minority of people with headache disorders worldwide are professionally diagnosed, with the rate for migraine and tension-type headaches being about 40 per cent and 10 per cent for headaches related to medication overuse, according to the study.
Specialists reported using International Headache Society diagnostic criteria to support diagnosis in 56 per cent of countries that responded to the study questionnaire. Usage was lower in Africa, the Eastern Mediterranean and South-East Asia and very low in poorer countries generally.
Instruments to assess impact of headache are used routinely in only 24 per cent of countries that responded, and very little in lower middle- or low-income countries, the report shows.
Worldwide, about 50 per cent of people with headaches are estimated to primarily treat themselves without contacting health professionals. Only about 10 per cent are seen by neurologists, with the rate even lower in Africa and South-East Asia.
Among specific anti-migraine drugs, ergotamine is more widely available than triptans, although the latter is more effective and less toxic, but more expensive, according to the WHO study.
Countries in all income categories identified non-availability of appropriate medication as a barrier to best headache management, which probably refers to limited reimbursement by health insurers.
The study pointed out that financial costs of headaches to society through lost productivity are enormous – far greater than the health care expenditure on headaches in any country.
“Health care for headache must be improved, and education is required at multiple levels to achieve this,” WHO says in the study. “Most importantly, health-care providers need better knowledge of how to diagnose and treat the small number of headache disorders that contribute substantially to public ill-health.”
Given the very high indirect costs of headaches, greater investment in health care that treats headaches effectively, through well-organized health services and supported by education, may well be cost-saving overall, the study advises.