How can we close the treatment gap?
in Philadelphia, tells SELF. “She said when she goes in wearing sweatpants, she isn’t taken as seriously. That’s the game us people of color have to play.”Socioeconomic status, insurance status, and geography can all present obstacles when it comes to getting. In general, people who have lower incomes tend to experience worse health outcomes than those who have higher incomes. What’s more, migraine prevalence is strongly associated with annual household income as well.
Insurance can also be an issue. Research shows that people who are uninsured and those with government-assisted insurance receive substandardChappell has noticed this when she goes to the doctor: “Being on government-assisted insurance, a lot of times they treat me like I’m beneath them, like I don’t even deserve to be treated,” she says. Another problem she experiences is not being able to get the medications she needs.
Where you live may also be an obstacle to migraine care. There are only 706 certified headache specialists in the country, and many states have two or fewer headache specialists.“Urban centers have more headache specialists than more rural areas,” Dr. Kiarashi says. “And most headache specialists who train at fellowship programs, which are located in urban settings, tend to stay where they train afterward.
This stereotype could be part of the reason why marginalized groups are underrepresented in migraine studies. When Dr. Kiarashi and her colleagues analyzed papers published inover the course of 2019, they found that more than 75% of participants were white. They noted: “This bias is not due to underlying rates of migraine, but due to the failure of recruitment efforts to obtain representative samples.
There’s also a lack of diversity amongst doctors and researchers designing and conducting studies. For example, when Chappell needs to go to the E.R., she tends to see lots of Black patients, “but there are no Black doctors who can relate or try to help,” she says. That’s a problem, since doctors of color may be better able to help patients of color: One study found that Black men respond better when paired with a Black doctor , which led to improved health outcomes.
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