{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T13:38:00Z","timestamp":1794231480731,"version":"4.9.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between family income to poverty ratio (PIR) and severe headache\/migraine remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data for this cross-sectional study were obtained from NHANES 1999\u20132004. PIR was the exposure variable, and severe headache\/migraine was the dependent variable. We performed univariate analyses of severe headache\/migraine, PIR, and other covariates. The association between PIR and severe headache\/migraine was tested using multiple regression models. Furthermore, interaction tests and stratified analyses assessed the relationship between PIR and severe headache\/migraine across subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were a total of 8,800 participants: 4,833 (54.92%) males and 3,967 (45.08%) females, 1,714 (19.48%) with severe headache\/migraine and 7,086 (80.52%) without severe headache\/migraine. After adjustment for all variables, PIR negatively correlated with severe headache\/migraine OR\u202f=\u202f0.86 95% CI (0.83, 0.90)\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001. The variable PIR was categorized as the low-income (PIR &amp;lt; 1), the middle-income (1 \u2264 PIR &amp;lt; 4), and the high-income (PIR \u2265 4). Notably, there was a significant difference in trend for the high-income group (PIR \u2265 4) compared to the control low-income group (PIR &amp;lt; 1) (all\n                      <jats:italic>P<\/jats:italic>\n                      for interaction&amp;lt;0.05). Dose\u2013response correlations were also analyzed using smoothed curve fitting, revealing a negative correlation between PIR and severe headache\/migraine (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001). Subgroup analysis results indicated that the negative association between PIR and severe headache\/migraine was more pronounced in the following populations: males (OR\u202f=\u202f0.84 95% CI (0.79, 0.90), &amp;lt;60\u202fyears old [Age\u202f&amp;lt;\u202f45 group OR\u202f=\u202f0.81 95% CI (0.76, 0.85)], Age 45\u201360 group OR\u202f=\u202f0.86 95% CI (0.79, 0.93), and those with education levels \u2265high school [High School OR\u202f=\u202f0.87 95% CI (0.81, 0.95), &amp;gt;High School OR\u202f=\u202f0.82 95% CI (0.78, 0.87)].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is a negative correlation between PIR and the incidence of severe headaches\/ migraine in Americans aged 20\u202fyears or older. This study has implications for the comprehensive management of patients with severe headache\/migraine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2024.1427277","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:10:33Z","timestamp":1731888633000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Association between family income to poverty ratio and severe headache\/migraine in the American adults: data from NHANES 1999\u20132004"],"prefix":"10.3389","volume":"15","author":[{"given":"Lingling","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Neurology, Northwest University First Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongjian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwest University First Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"You","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwest University First Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junpeng","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwest University First Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwest University First Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haili","family":"Di","sequence":"additional","affiliation":[{"name":"Department of Neurology, Northwest University First Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s10194-020-01208-0","article-title":"Migraine remains second among the world\u2019s causes of disability, and first among young women: Findings from GBD2019","volume":"21","author":"Steiner","year":"2020","journal-title":"J Headache Pain"},{"key":"ref2","author":"Zhang","year":"2023"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s10194-024-01712-7","article-title":"Health equity, care access and quality in headache\u2013part 1","volume":"25","author":"Tana","year":"2024","journal-title":"J Headache Pain"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1016\/S0002-9149(01)01554-5","article-title":"Socioeconomic status as an independent risk factor for hospital readmission for heart 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