Ethnicity, gender and social class shape migraine experience
New research reveals inequities in healthcare and beyond
A new report from The Migraine Trust has revealed that people’s experience of migraine, one of the world’s most disabling neurological conditions, is shaped not just by their symptoms, but by their gender, ethnicity and social background.
The research, which is the first of its kind, reveals stark inequalities in how the condition is experienced with those who already face, or who anticipate, discrimination much less likely to disclose or seek support. It found how people think they are perceived already has a significant impact on whether they feel able to tell others about their migraine in the workplace, when accessing healthcare and with family and friends.
Migraine affects one in seven people, with around one million living with chronic migraine.
Key findings include:
- 92% of all participants said migraine affects their ability to work, and 95% said it impacts their education. Four in five (79%) reported a negative effect on their mental health
- Women were more likely to not want to disclose their migraine for fear of being seen as “emotional” or unreliable, while men cited concerns about being perceived as weak
- Those with Black heritage were most likely to fear discrimination or a negative impact on their career compared to white colleagues (37% v 26%)
- 23% of mixed-ethnicity, 19% of Asian, and 16% of Black respondents said their ethnicity had negatively affected their care. With some talking about poorer treatment, being stereotyped or looked down on because of their ethnicity. This compared with just 7% of white participants
The findings highlight how stigma and societal expectations intersect with identity, compounding the impact of migraine. 19% of Asian and 14% of Black respondents said they worry they wouldn’t be believed about their migraine, compared to just 8% of white respondents.
It is sad to see that so many people avoid seeking support for, or even talking about their migraine for fear it carries social penalties including job loss and stereotyping. For some, migraine is not only a health condition but adds an additional layer of inequality with gender, ethnicity and social grade all impacting how they are treated or expected to be treated. We cannot let this continue and need action across all levels of society so that people with migraine feel understood, safe and heard.
In healthcare, 91% of participants had spoken to a health professional about their migraine, yet many reported being misdiagnosed, dismissed, or inadequately treated. Women described being told their migraine was hormonal or “just part of being a woman,” while younger people felt they were dismissed as exaggerating or seeking attention. People from ethnic minorities described being ignored, disbelieved or stereotyped, with some citing direct discrimination or poorer treatment.
When looking across social grade, those in C2DE groups felt less prioritised and less respected compared to ABC1 respondents, believing class impacts the speed and quality of care. As a result many described coping alone and relying on self-management strategies.
Growing up, I didn’t know anyone like me who lived with migraine. It was isolating, and after so many poor experiences, the lack of validation made me feel like it really was just me. As a young girl, my symptoms were brushed off as ‘just hormones.’ Later, as a Black woman, the stereotype that we can tolerate more pain deeply affected the care I received. Migraine is already hard enough to explain, there shouldn’t be extra barriers like gender or the colour of your skin making it even harder.
Worrying distinctions were also found in the workplace, where many people choose to conceal their migraine from employers or colleagues. Some feared disciplinary action, job loss, or being labelled “difficult” or “unreliable.” Others cited embarrassment or previous dismissive experiences as reasons they no longer seek help.
- More than a third of Black respondents (37%) said they feared workplace discrimination if they disclosed their condition, compared with a quarter of white respondents (26%)
- Across social grade, half (49%) of those from lower-income (C2DE) backgrounds said they had worked through a migraine attack because they couldn’t afford to take time off, compared to one in three (33%) of those from higher-income (ABC1) groups. Fears of job security and lack of flexibility were significant barriers to disclosure among C2DE backgrounds with ABC1 participants more likely to worry about their reputation and perceived reliability or potential impact on their career progression
This report shines a harsh and necessary light on the reality that migraine is not experienced equally. Your gender, ethnicity or income should never determine whether you are believed, supported, or able to access the care you need, yet that is precisely what too many people living with migraine are facing. These findings echo what we see across the neurological community: people being dismissed, misdiagnosed, or left to cope alone because the system is not designed with them in mind. We urgently need action from employers, healthcare leaders and policymakers to close these gaps. Tackling the inequalities laid bare in this report is essential if we are serious about improving neurological care and ensuring no one is left behind.
Working in jobs paid by the hour, and without sick pay, means it is so much harder on me if I take time off when I have a migraine attack. Social class definitely impacts my migraine experience as I often have to just push through, which can be incredibly hard to do. I’ve sometimes been lucky and had supportive managers who have wanted to understand my migraine, but if I hadn’t, I’m not sure I’d have been able to last in a career that I love.
I work in a very male dominated environment where people don’t show weakness, it’s about who is the toughest and who cares the least. When I needed time off during an attack, I’d get ridiculed and instead just keep it quiet. I still feel apprehensive when talking to people about not being able to make plans. It can feel embarrassing to bail out of nights out or weekends away for what people think is just a headache. Even though migraine is a complex neurological condition completely out of my control. Now that I’ve lived with migraine for almost 20 years and people have seen me have an attack, it’s got easier to talk about, but it’s taken a long time to get to a point where it feels like people take it seriously.
My work involves late nights and different shift patterns and the change in pattern can trigger a migraine attack. At times I’ve had three migraine attacks in a week but I’m often reluctant to tell anyone as I’m self-employed so I don’t get paid sick leave. People hear ‘migraine’ and think ‘headache’, an attack for me involves intense neck pain, spasms, brain fog, excruciating eye pain, in addition to head pain. The financial cost of missing work is just too high when I need to pay my rent and bills. It can be really stressful and stress is another trigger.
Ends
Notes to Editors
- The Migraine Trust is the UK’s leading charity for people affected by migraine. The charity campaigns for awareness, better treatment, and equitable support for the one in seven people living with migraine.
- The full report can be found here: ’The migraine divide: how gender, ethnicity and social grade impact experience of migraine in the workplace, in healthcare and day to day life’
- The research combined a literature review and social listening with quantitative research using a representative sample of 2,200 people with migraine. All were over 18 and lived in the UK and included oversampling from Black and Asian communities including Bangladeshi, Pakistani, Black Caribbean, Black African and Black British to ensure sufficient representation. The findings informed in-depth, qualitative research with eighteen interviews which considered a diverse range of backgrounds including ethnicity, education levels, employment, relationship and parental status
- Teva UK Limited provided funding for this health awareness activity, but had no involvement in the production, final content, or resulting outputs
