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The Prevalence of Headache and Its Association
with Socioeconomic Status among Schoolchildren
in Istanbul, Turkey
Ugur Isik, MD; Ahmet Topuzoglu, MD; Pinar Ay, MD; Refika Hamutcu Ersu, MD; Ayse Rodopman Arman, MD; M. Fatih Onsuz, MD; Melda Karavus, MD; Elif Dagli, MD
Posted: June 2009  
Headache   2009;49(5):697-703

Objective:   The etiology and pathogenesis of migraine and other types of headache are still under discussion. An interaction of organic, psychological, and psychosocial factors is operative. In this study, we aimed to determine the prevalence of headache and its association with socioeconomic status among schoolchildren.

Study Design:  A cross-sectional study was performed on 2669 schoolchildren via a parental questionnaire. Socioeconomic status was determined according to the Turkish socioeconomic status scale.

Results:  The mean age of the students was 8.2 ± 2.4 years. The headache prevalence was 46.2% (95% CI: 44.3-48.1). The prevalence of migraine was 3.4% (95% CI: 2.8-4.1), the prevalence of probable migraine was 8.7% (95% CI: 7.6-9.8), and that of non-migraine headache was 34.1% (95% CI: 32.2-35.9). Multivariate analysis revealed that older age, being a girl, having a family history of headache, and exposure to passive smoking at home were independently associated with headache. There was an inverse association between socioeconomic status and all 3 types of headaches after adjusting for age, sex, family history of headache and presence of passive smoking. When the group with the lowest socioeconomic status was taken as the reference category, the odds ratio for the highest socioeconomic group were 0.33 (95% CI: 0.16-0.69, P=.003) for the migraine, 0.30 (95% CI: 0.11-0.89, P=.029) for the probable migraine, and 0.34 (95% CI: 0.16-0.72, P=0.005) for the non-migraine headache.

Conclusion:  Headache is more common among children in lower socioeconomic groups. Social causation can play a role in the pathogenesis of headache.