Q&A: 1 in 3 people had a headache disorder in 2023

Nearly 1 in 3 individuals were affected by headache disorders in 2023 — a total of 3 billion people around the world. 

More than one-fifth of the global headache burden was linked to pain medication overuse, highlighting major opportunities for safer pain management and improved access to care, according to a new study from IHME and Norwegian University of Science and Technology (NTNU).

Yvonne Xu, co-author and research scientist at IHME, discusses the key findings from this research.

Read the study, published in The Lancet Neurology.

Video transcript

This transcript has been lightly edited for clarity

Why is understanding the global burden of headache so important?

Headache disorders is often overlooked as a major health condition that heavily impacts a person’s ability to engage in daily activities, leading to overall health loss and productivity loss. It’s one of the most common and disabling health conditions worldwide, and this study provides age-specific and sex-specific estimates of health loss due to headache disorders owing to migraine, tension-type headaches, and medication overuse headaches, from 1990 to 2023.

And by quantifying this impact, our study is able to inform policies that can strengthen recognition, prevention, and management of headache disorders for those most affected.

What were the study’s key findings, and what is new about this study?

Our study found that headache disorders affected almost 3 billion people worldwide in 2023. That’s nearly one in every three people. And it’s ranked sixth among all causes of years lived with disability. We also found that there’s no meaningful change in headache burden over the last 30 years, suggesting that the root causes remain untouched. And between migraine and tension-type headaches, migraine causes nearly 90% of all disability due to headache disorders, even though tension-type headache was twice as prevalent as migraine.

Among all the global health headache burden, over 20% is linked to medication overuse, highlighting the major opportunities for safer pain management and improved access to care. And in our GBD 2023 analysis – it builds on previous work – and in this round, we newly included major refinements to estimating YLDs by using high-quality data from over 40,000 respondents representing 18 different countries.

This incorporates differences in headache duration and frequency, which we observed between sex and age, and its differential contribution to YLDs.

What gender and geographical differences did you find?

One of the key findings from this update is that women experience more than twice the headache-related health loss compared to men, and this is due to two main reasons. So one, prevalence of migraine among women is twice that of men. And second, regardless of migraine or tension-type headache, on average, women experience headaches more frequently and for a longer period of time compared to men.

In this graph, we can see the global age-standardized rates of YLDs attributed to migraine and tension-type headache, migraine in purple and tension-type headache in green. The left panel shows males. The right panel shows females. And we’re showing time trends from 1990 to 2023.

When we compare between males and females, differences in YLDs attributed to tension-type headache are small, but for YLDs attributed to migraine, the rate among women is more than twice the rate compared to men.

In terms of geographical differences, the highest rates of disability from migraine were seen in North Africa and the Middle East and lowest in sub-Saharan Africa. For tension-type headache, highest rates of disability were seen in Central Europe, Eastern Europe, and Central Asia, and lowest in Southeast Asia, East Asia, and Oceania.

However, we caution against overly granular geographical comparisons because prevalence data were scarce in numerous countries, especially in low- and middle-income countries, and particularly with regard to tension-type headache and medication overuse. But overall, the burden of headache disorders is high worldwide, and the differences across regions are small.

How do you hope the findings of the study will be used?

So the study highlights that headache disorders remain a major, yet under-recognized, global health priority. We hope that our study can shine a light on this issue and call for more research and policy actions toward reducing health loss due to headache disorders globally, especially with a focus on migraine, given its disproportional contribution. We found that a large part of the burden could be preventable if effective and affordable treatments are available.

However, access to appropriate care and education remains limited in many settings, so strengthening primary care to include headache diagnosis and management, improving education for patients and health providers, and promoting safe medication practices are all key steps toward reducing the burden globally. And, hopefully, this can greatly improve productivity, well-being, and quality of life for millions of people worldwide.