The Impact of Migraine Headaches and Depression on Health Behaviors Among Veterans, Insights from The Million Veteran Program

Migraine and depression are common among Veterans and linked to adverse health behaviors and outcomes, yet the interaction between them is poorly understood. Using self-report data from 283,377 Veterans enrolled in the Million Veteran Program, we examined disparities in health behaviors among Veterans with and without a lifetime history of migraines and depression. We explored the interaction between depression and migraines in relation to five health outcomes: sleep duration, physical activity level, exercise frequency, smoking status, and alcohol use. Migraine was reported by 9% of Veterans, of which 53.45% also reported having a history of depression. In models adjusting for age, race, ethnicity, income, education, and BMI, migraine, and depression contributed to worse outcomes in all categories except smoking (ps <.001). Interaction effects between migraine and depression were significant for smoking behavior (OR = 0.89 (95% CI [0.84 - 0.95]) 11% more likely to be a never than former smoker), and physical activity level (rarely active 20% more likely than moderate or vigorous activity: OR = 0.79 (95% CI [0.72 - 0.86]) & 0. 73 [0.67 - 0.79] all ps <.001; F (10, 2) = 12.91, p =.001; F(10,2) = 80.58, p <.001, respectively) indicating that individuals with both conditions had mixed outcomes distinct from individual migraine and depression effects. Results suggest that depression and migraine have a synergistic association with health behaviors, especially smoking and physical activity. Tailored interventions, including comprehensive management and care for Veterans with migraines, are important and supported by these results. Funded by IK2CX002107, IK2RX003634.