Rethinking headache as a global public health case model for reaching the SDG 3 HEALTH by 2030

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Abstract

The 2030 Agenda for Sustainable Development sets out, through 17 Sustainable Development Goals (SDGs), a path for the prosperity of people and the planet. SDG 3 in particular aims to ensure healthy lives and promote well-being for all at all ages and includes several targets to enhance health. This review presents a “headache-tailored” perspective on how to achieve SDG 3 by focusing on six specific actions: targeting chronic headaches; reducing the overuse of acute pain-relieving medications; promoting the education of healthcare professionals; granting access to medication in low- and middle-income countries (LMIC); implementing training and educational opportunities for healthcare professionals in low and middle income countries; building a global alliance against headache disorders. Addressing the burden of headache disorders directly impacts on populations’ health, as well as on the possibility to improve the productivity of people aged below 50, women in particular. Our analysis pointed out several elements, and included: moving forward from frequency-based parameters to define headache severity; recognizing and managing comorbid diseases and risk factors; implementing a disease management multi-modal management model that incorporates pharmacological and non-pharmacological treatments; early recognizing and managing the overuse of acute pain-relieving medications; promoting undergraduate, postgraduate, and continuing medical education of healthcare professionals with specific training on headache; and promoting a culture that favors the recognition of headaches as diseases with a neurobiological basis, where this is not yet recognized. Making headache care more sustainable is an achievable objective, which will require multi-stakeholder collaborations across all sectors of society, both health-related and not health-related. Robust investments will be needed; however, considering the high prevalence of headache disorders and the associated disability, these investments will surely improve multiple health outcomes and lift development and well-being globally.

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Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Theo Vos, Stephen S Lim, Cristiana Abbafati … (2023)

Summary Background In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and development investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding Bill & Melinda Gates Foundation.

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Global prevalence of chronic migraine: a systematic review.

J Natoli, A Manack, B. Dean … (2010)

The aim of this review was to summarize population-based studies reporting prevalence and/or incidence of chronic migraine (CM) and to explore variation across studies. A systematic literature search was conducted. Relevant data were abstracted and estimates were subdivided based on the criteria used in each study. Sixteen publications representing 12 studies were accepted. None presented data on CM incidence. The prevalence of CM was 0-5.1%, with estimates typically in the range of 1.4-2.2%. Seven studies used Silberstein-Lipton criteria (or equivalent), with prevalence ranging from 0.9% to 5.1%. Three estimates used migraine that occurred ≥15 days per month, with prevalence ranging from 0 to 0.7%. Prevalence varied by World Health Organization region and gender. This review identified population-based studies of CM prevalence, although heterogeneity across studies and lack of data from certain regions leaves an incomplete picture. Future studies on CM would benefit from an International Classification of Headache Disorders consensus diagnosis that is clinically appropriate and operational in epidemiological studies.

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Migraine: epidemiology and systems of care

Messoud Ashina, Zaza Katsarava, Thien Do … (2021)

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Author and article information

Contributors

Alberto Raggi: alberto.raggi@istituto-besta.it

Journal

Journal ID (nlm-ta): J Headache Pain

Journal ID (iso-abbrev): J Headache Pain

Title: The Journal of Headache and Pain

Publisher: Springer Milan (Milan )

ISSN (Print): 1129-2369

ISSN (Electronic): 1129-2377

Publication date (Electronic): 27 October 2023

Publication date PMC-release: 27 October 2023

Publication date Collection: 2023

Volume: 24

Issue: 1

Electronic Location Identifier: 140

Affiliations

[1 ]Department of Clinical and Molecular Medicine, Sapienza University, ( https://ror.org/02be6w209) Rome, Italy

[2 ]GRID grid.417894.7, ISNI 0000 0001 0707 5492, Neurology, Public Health and Disability Unit, , Fondazione IRCCS Istituto Neurologico Carlo Besta, ; Via Celoria 11, Milan, 20133 Italy

[3 ]Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, ( https://ror.org/035b05819) Copenhagen, Denmark

[4 ]John Hedley-Whyte Professor of Anesthesia and Neuroscience at the Beth Israel Deaconess Medical Center and Harvard Medical School, ( https://ror.org/04drvxt59) Boston, MA USA

[5 ]GRID grid.488450.5, ISNI 0000 0004 1790 2596, Department of Neurology, Dongtan Sacred Heart Hospital, , Hallym University College of Medicine, Military Hospital, ; Hwaseong, Korea

[6 ]37 Military Hospital, ( https://ror.org/00txnqh94) Accra, Ghana

[7 ]Department of Neurology, Mayo Clinic, ( https://ror.org/03zzw1w08) Scottsdale, AZ USA

[8 ]Neurology Department, Hospital da Luz Headache Center, Hospital da Luz Lisboa., ( https://ror.org/03jpm9j23) Lisbon, Portugal

[9 ]Center for Interdisciplinary Research in Health, Universidade Católica Portuguesa, ( https://ror.org/03b9snr86) Lisbon, Portugal

[10 ]GRID grid.417894.7, ISNI 0000 0001 0707 5492, Neuroalgology Unit and Headache Center, , Fondazione IRCCS Istituto Neurologico Carlo Besta, ; Milan, Italy

[11 ]Department of Neurology and Stroke Unit, Koventhospital Barmherzige Brüder Linz, ( https://ror.org/01fxzb657) Linz, Austria

[12 ]Headache Medical Center Linz, Linz, Austria

[13 ]Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus MC University Medical Center, ( https://ror.org/018906e22) Rotterdam, Netherlands

[14 ]GRID grid.240324.3, ISNI 0000 0001 2109 4251, Department of Neurology, , NYU Langone Health, ; NY New York, USA

[15 ]GRID grid.5216.0, ISNI 0000 0001 2155 0800, 1st Neurology Department, Eginition Hospital, Medical School, , National and Kapodistrian University of Athens, ; Athens, Greece

[16 ]Faculty of Clinical Sciences; Center for Genomic and Precision Medicine, College of Medicine,, University of Ibadan, ( https://ror.org/03wx2rr30) Ibadan, Nigeria

[17 ]Department of Neurology, Charité Universitätsmedizin Berlin, ( https://ror.org/001w7jn25) Berlin, Germany

[18 ]GRID grid.412469.c, ISNI 0000 0000 9116 8976, Universitätsmedizin Greifswald, ; Greifswald, Germany

[19 ]European Migraine and Headache Alliance, Brussels, Belgium

[20 ]Department of Biotechnological and Applied Clinical Sciences, University of L‘Aquila, ( https://ror.org/01j9p1r26) L‘Aquila, Italy

[21 ]Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, ( https://ror.org/0107c5v14) Genoa, Italy

[22 ]IRCCS Ospedale Policlinico San Martino, ( https://ror.org/04d7es448) Genoa, Italy

[23 ]Surya Neuro Centre Mumbai, Mumbai, India

[24 ]Department of Brain and Behavioral Sciences, University of Pavia, ( https://ror.org/00s6t1f81) Pavia, Italy

[25 ]GRID grid.419416.f, ISNI 0000 0004 1760 3107, Headache Science and Neurorehabilitation Center, , IRCCS Mondino Foundation, ; Pavia, Italy

[26 ]Brain Research Center, National Yang Ming Chiao Tung University, ( https://ror.org/00se2k293) Taipei, Taiwan

[27 ]Department of Neurology, The Neurological Institute, Taipei Veterans General Hospital, ( https://ror.org/03ymy8z76) Taipei, Taiwan

[28 ]Headache Center, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, ( https://ror.org/013xs5b60) Beijing, China

[29 ]Department of Neurology, Sunshine Hospital, ( https://ror.org/033abcd54) St Albans, VIC Australia

Article

Publisher ID: 1666

DOI: 10.1186/s10194-023-01666-2

PMC ID: 10604921

PubMed ID: 37884869

SO-VID: 460af298-cbd2-40f1-88db-d00a4c0e5134

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 1 August 2023

Date accepted : 5 September 2023

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ScienceOpen disciplines: Anesthesiology & Pain management

Keywords: migraine,medication overuse headache,tension-type headache,sustainable development goals,global burden of disease study,low- and middle-income countries

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ScienceOpen disciplines: Anesthesiology & Pain management

Keywords: migraine, medication overuse headache, tension-type headache, sustainable development goals, global burden of disease study, low- and middle-income countries

Rethinking headache as a global public health case model for reaching the SDG 3 HEALTH by 2030

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UN Sustainable Development Goals

Most cited references 94

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Global prevalence of chronic migraine: a systematic review.

Migraine: epidemiology and systems of care

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