In the absence of up-to-date national statistics on migraine in Aotearoa New Zealand, we rely on estimates from the Global Burden of Disease (GBD) study. This is an international research project that draws on data from around the world to estimate and compare the prevalence, mortality and disability impact of a large range of diseases, including migraine.
The GBD study recently updated its database for 2021. Globally, migraine affects around 1,160,000 people, with a prevalence of 14% (18% for females and 11% in males).
In NZ, 753,000 people were estimated to have migraine in 2021, including 464,000 females and 289,000 males. This is a big jump from the previous estimate of 642,000 that we have been using, with updated Census data and accounting for a growing population. The prevalence of migraine in NZ was the same as the global estimate of 14%.
The last national survey in NZ that asked about migraine was the NZ Health Survey 2013/14. This estimated an overall migraine prevalence of 16% (20% in females and 11% in males). The slightly higher estimate from the NZ Health Survey is likely because this asked about having ever been diagnosed with migraine by a doctor (which is a measure of migraine over the lifetime) whereas the GBD estimates are based on experience of migraine in the last year (an annual measure).
The GBD study does not report on ethnicity but the NZ Health Survey found a similar prevalence of migraine in NZ European, Māori and Pacific people.
Out of all the neurological conditions, globally, migraine is the third highest cause of health loss (measured by disability-adjusted life years, DALYs). However, in Australasia and Western Europe, migraine is the number one cause of loss of DALYs from neurological conditions.1 This is extraordinary, given that DALYs measure health loss from both premature death (years of life lost, YLLs) and disability (years lived with disability, YLD), and migraine on its own is not a fatal disease. But because it is so common, affects people from a young age and over the lifespan, and has such a high disability burden, it has a higher impact at a population level than neurological conditions that are less common, affect older people or have a devastating impact over a relatively short time period, including stroke, dementia, autism spectrum disorder, brain cancer and Parkinson’s disease.
Other research has estimated that migraine accounts for around 5% of global population ill health, as measured by years lived with disability (YLD).2 Since this measure only includes the disability impact of disease and not the impact on mortality, it is more appropriate for a disease like migraine. Using this measure, globally migraine is the fourth highest cause of years lived with disability from the 2021 GBD study (below low back pain, major depression and age-related hearing loss), but second for adults aged under 50 years.3
What’s new from these data are better estimates for children aged 5-14 years. Globally, headache disorders (which includes migraine) are estimated to be the fourth highest cause of YLDs in children; the 8th highest cause in high income countries such as NZ.3 This needs more attention, not only because of the direct impact of headache disorders on the child, their family and their education, but because headache in childhood may increase the chance of migraine in adulthood.4 Effective management of childhood headache might reduce this, or reduce the impact.
References
- Steinmetz, J. D. et al. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol 23, 344–381 (2024).
- Steiner, T. J. & Stovner, L. J. Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol (2023) doi:10.1038/S41582-022-00763-1.
- Steiner, T. J., Husøy, A. & Stovner, L. J. GBD2021: headache disorders and global lost health – a focus on children, and a view forward. J Headache Pain 25, 91 (2024).
- Waldie, K. E. Childhood Headache, Stress in Adolescence, and Primary Headache in Young Adulthood: A Longitudinal Cohort Study. Headache: The Journal of Head and Face Pain 41, 1–10 (2001).
