Q&A: Global burden of headache disorders

Headache disorders, especially migraine and tension-type headache, are among the most common and disabling conditions worldwide. They rank as the second most prevalent condition overall and the third-leading cause of disability, affecting billions of people. IHME Collaborator Dr. Jiyeon Oh discusses research that examined the global burden of headache disorders.

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Transcript

This transcript has been lightly edited for clarity

Why is it important to study the burden of headache disorders, and how do they impact health and lives?

So headache disorders, especially migraine and tension-type headache, are among the most common and disabling conditions worldwide. They rank as the second most prevalent condition overall and the third-leading cause of disability. Affecting billions of people, they substantially impair productivity, quality of life, and mental health. Yet because they’re not fatal, they remain underdiagnosed, undertreated, and often overlooked in public health priorities.

What were the key findings of the study from 1990 through 2021?

So from 1990 to 2021, we found that the number of people living with migraine or tension-type headache increased by more than 50%. However, the age-standardized rates remained relatively unchanged, meaning that the rise is mainly due to population growth and aging. The burden was consistently higher among women and peaked during young to middle adulthood. We also found clear geographical patterns, such as high-income countries reported a higher burden, reflecting both greater diagnostic awareness and modern lifestyle factors.

In contrast, in low-income countries, headache disorders often receive lower priority compared to fatal diseases such as infections or cardiovascular conditions, which may lead to underdiagnosis and limited access to appropriate care.

What does your study forecast for the burden of headache disorders through 2050?

By 2050, the total number of years lived with disability (YLDs) due to headache disorders is projected to rise about 20%, mainly because of global population growth and aging. However, the age- standardized years lived with disability (YLD) rates are expected to remain stable, suggesting that the individual risk of developing disabling headaches is not increasing. In other words, the global burden will grow not because people are getting sicker but because there will be more people affected overall.

This figure shows how the burden of migraine is projected to change across regions by 2050. The teal bars represent the contribution of population growth, which is clearly the dominant factor everywhere. Aging has a smaller effect, and epidemiological change is minimal, indicating that migraine burden will rise mainly because of demographic expansion rather than worsening disease risk.

The pattern for tension-type headache is very similar. So most of the increase through 2050 will be due to population growth, with little epidemiological change. A few regions, such as Central and East Asia, may even experience modest declines in rates, suggesting that demographic trends rather than clinical deterioration drive the global burden increase in disability.

What strategies are needed to reduce the burden of headache disorders moving forward?

Looking forward, I see two main directions. First, we need to strengthen data and research by incorporating key lifestyle-related risk factors such as stress, poor sleep, and physical inactivity into future GBD analysis. These are highly relevant but currently unmeasured contributors to headaches. Second, from a policy and clinical perspective, a stronger focus on women’s health and workplace well-being is essential given that headache disorders disproportionately affect young and middle-aged females.

So, together, these actions can help elevate headache disorders from an overlooked issue to a clearly recognized global health priority.