An Analysis on How Socioeconomics and Geographical Factors Influence Recognition of Sport-related Concussion in the Lone Star State
Sarah Bivans1, Joshua Beitchman1, Cason Hicks1, Christine Woods1, Munro Cullum1, Mathew Stokes1
1University of Texas Southwestern Medical Center
Objective:
To assess how sociodemographic factors influence recognition of sport related concussion (SRC).
Background:
SRC affects high-school athletes’ ability to participate academically and socially. Inherent disparities amongst schools’ disproportionate access to resources may impact rates of reported SRC.
Design/Methods:
This retrospective review of prospectively collected data from Rank One, a database of athletic injuries, identified 6,377 cases of reported SRC among Texas high-school athletes across 16 sports and 289 schools from 2021-2023. Athletes were analyzed by geographic location (city, suburb, rural) and socioeconomic status (SES; high, average, low). Incidence rates were defined as number of reported SRC per 1000 students. Statistics were completed using Chi square for comparisons of individual sports, with significance set at p<0.05.
Results:
Athletes participating in football comprised the largest percentage of total reported SRC (37.42%), followed by soccer (18.8%) and basketball (11.87%). Reports of SRC by geographic location revealed cities had a smaller percentage of total SRC than suburbs in marching band (0.12% vs 0.58%), swimming/diving (0.60% vs 1.58%), water polo (0.36% vs 1.10%), and wrestling (5.14% vs 8.67%). Evaluation of reported SRC by SES indicated lower SES schools had a smaller percentage of reported SRC in marching band (0.06% vs 0.53%) and cheerleading (3.05% vs 4.60%) with more reported SRC in softball (7.6% vs 5.17%). Similar percentages of reported SRC were described in other sports across SES and geographic location. Lower incidence rates of SRC were found in schools in cities and schools of lower SES. Regional evaluation identified higher incidence of SRC associated with areas of higher SES.
Conclusions:
Athletes in urban and lower SES schools had fewer reported SRC in less populous sports and lower incidence rates compared to their counterparts in suburban, and higher SES schools. Targeted interventions, focused on sports that may be currently overlooked, are needed to address sociodemographic disparities in SRC.