We at CHAMP see the disparities that exist in our healthcare system. The group identified by the US government as American Indian/Alaska Native has the highest prevalence of migraine or severe headache disorders (22.1%),¹ as well as the highest rates of traumatic brain injury (TBI) and concussion.² The prevalence is likely even more significant when taking into account that many individuals with migraine and headache disorders are misdiagnosed or undiagnosed.³ ⁴ We strive to do what we can to help alleviate those disparities. We have partnered with the Indigenous Migraine and Headache Advisory Forum and hope that the following resources are helpful.
Indigenous Migraine and Headache Advisory Forum (IMHAF)
IMHAF recognizes that people indigenous to Canada and the United States and its territories, including Native Hawaiians, other Pacific Islanders, “American Indians,” and Alaska Natives face unique challenges:
- Little research has been done on the experience and impact of migraine and headache disorders in Indigenous populations.⁵
- Indigenous populations are underrepresented in clinical trials on migraine and headache disorders.⁶
- Indian Health Service (IHS) is chronically underfunded and understaffed;⁷ there is little to no access to neurologists and United Council for Neurological Subspecialties certified headache specialists.⁸
- To our knowledge, only a handful of providers who specialize in headache medicine work at Indigenous Health Centers.
- To our knowledge, newer effective evidence-based migraine and headache treatments are rarely available at Indigenous Health Centers.
IMHAF was established out of a desire for meaningful engagement among headache disorder education/advocacy groups, healthcare providers serving Indigenous communities, and Indigenous communities and patients.
Purpose: To improve access, care, and outcomes for Indigenous people living with migraine and headache disorders.
Objectives:
- To identify gaps in Indigenous healthcare needs.
- To empower and support Indigenous communities in addressing the challenges associated with treatment, access, and continuity of care.
- To promote culturally competent healthcare practices and advocate for improved healthcare services for Indigenous Peoples.
- To facilitate research, education, and awareness initiatives for Indigenous Peoples.
- To create a collaborative network that brings together healthcare professionals, Indigenous leaders, patients, and relevant stakeholders to share knowledge and expertise.
- To act only on desires expressed by the community.
Sign up to receive updates about IMHAF’s work and ways to get involved >>
For more information:
- Visit IMHAF’s Resource Hub: https://linktr.ee/imhaf22.1
- Contact IMHAF via email: imhaf.info@gmail.com or phone: 918-308-9299
Migraine and Headache Programming Featuring Indigenous Peoples
“More Than a Headache.” Native America Calling podcast. Art Hughes, host. Tuesday, December 4, 2018. 59 min.
“Ensuring Equitable Access to Migraine Treatment in the Native American and Alaskan Native Communities”. The Headache & Migraine Policy Forum. February 15, 2022.
Flags for Headache: Mary Herne’s Story, 2025. 5 min, 35 sec.
Interview with Mary Herne, FNP. Native Talk Arizona podcast. July 8, 2026. Listen on: Spotify, Apple Podcasts, or YouTube. 50 min, 59 sec.
GHWIC C2 Chronic Disease ECHO Webinar with Mary Hearne [sic]. March 31, 2026. 53 min, 13 sec.
Here Before, Hear Now Podcast: Dr. Yvette Brown-Shirley. Colton Shone, host. March 18, 2024. 27 min, 56 sec.
Concussion & Traumatic Brain Injury in Indigenous Communities: Practical, Culturally Informed Care with Guest Speaker: Yvette Brown-Shirley, MD. Mayo Clinic. August 2025. 1 hour, 4 sec.
Migraine and Headache Articles Featuring Indigenous Peoples
“Insight of a headache medicine provider in Indian Health Service: A personal and professional observation” by Mary Herne FNP-C and Larry Charleston IV, MD, MSc, FAHS. Headache: The Journal of Head and Face Pain, May 4, 2023.
“How My Service Dog Helps Me Cope With Migraine and Seizures” by Jules Thornton-Brison. Migraine Again, Updated on March 15, 2024.
Migraine and Headache Reports and Studies Featuring Indigenous Peoples
Ensuring Equitable Access to Migraine Treatment in the Native American and Alaskan Native Communities 2022 Report. The Headache & Migraine Policy Forum
Join a Support Group
U.S. Pain Foundation hosts a virtual Black, Indigenous, and People of Color chronic pain support group.
1 Burch RR. The prevalence and impact of migraine and severe headache in the United States: Updated age, sex, and socioeconomic-specific estimates from government health studies. Headache. 2021;61:60-68.
2 Burch RR. The prevalence and impact of migraine and severe headache in the United States: Figures and trends from government health studies. Headache. 2018;58:496-505.
3 Wang Z, Yang X, Zhao B, Li W. Primary headache disorders: From pathophysiology to neurostimulation therapies [review]. Heliyon. 2023;9:e14786.
4 Lipton RB, Nicholson RA, Reed ML, et al. Diagnosis, consultation, treatment, and impact of migraine in the US: Results of the OVERCOME (US) study. Headache. 2022;62(2):122-140.
5 Kiarashi J, VanderPluym J, Szperka CL, et al. Factors associated with, and mitigation strategies for, health care disparities faced by patients with headache disorders. Neurology. 2021;97(6):280-289.
6 Ibid.
7 Druse G, Lopez-Carmen VA, Jensen A, Hardie L, Sequist TD. The Indian Health Service and American Indian/Alaska Native health outcomes. Annu Rev Public Health. 2022;43:559-576.
8 Per Mike Stitzer, MD, IHS National Chief Clinical Consultant in Neurology. See also Herne MM, Charleston L IV. Insight of a headache medicine provider in Indian Health Service: a personal and professional observation. Headache. 2023;63:697-6