Migraine and Social Determinants of Health: a population-based, health disparities study of Arizona Medicaid recipients

Migraine and Social Determinants of Health: a population-based, health disparities study of Arizona Medicaid recipients Migraine and Social Determinants of Health: a population-based, health disparities study of Arizona Medicaid recipients Migraine is an extraordinarily prevalent neurological disease and the second overall cause for years lived with disability. There is limited literature pertaining to health disparities and migraine, which further exacerbates disparities for vulnerable populations and necessitates a deeper examination of the social determinants of health (SDoH) and lived experiences of communities with disproportionately poor migraine outcomes. Utilizing Arizona Medicaid (i.e., AHCCCS) claims data available through the Center for Health Information and Research (CHiR), there is a unique opportunity to examine the relationship between SDoH and migraine/headache diagnosis, evaluation, and treatment based on Z codes. Required since April 2018, Z codes are provided in the ICD-10-CM for the reporting of factors influencing health status such as education/literacy, employment, occupational exposures, housing, food security, transportation, and problems relating to social environment/upbringing/family circumstances/psychosocial circumstances. This retrospective review will test the hypothesis that increased exposure to negative SDoH is associated with lower rates of sub-specialty health care encounters, higher rates of receiving the non-specific diagnosis of headache over the specific diagnosis of migraine, and lower rates of guideline recommended prescriptions and diagnostic tests. This study will assess the frequency of migraine/headache diagnosis among all ages of AHCCCS recipients and describe the relationships between migraine/headache diagnoses with demographic variables including gender, age, race/ethnicity, and rural/urban residence. We will investigate the frequency and types of migraine/headache treatments that are prescribed, encounters with health providers for indication of migraine/headache, and utilization of diagnostic testing based on demographic variables and Z codes.