Racial Differences Identified in Concussion Recovery in Black and White Athletes

Neurology Advisor

November 8, 2021

Black athletes reached an asymptomatic status and went back to school earlier following sport-related concussion, according to study results published in the Journal of Neurosurgery: Pediatrics.

Prior research has identified several risk factors that impact recovery following sport-related concussion, but there is a dearth of research on the association of race on sport-related concussion or its aftermath, according to the study authors. Racism and racial biases have impacted health outcomes. The objective of the study was to compare outcomes and management of sport-related concussion among Black and White athletes.

The researchers included data of 247 (211 White, 36 Black; 57.8% White males, 77.8% Black males) pediatric and collegiate student-athletes (aged 12 to 23 years) in middle Tennessee, northern Alabama, and southern Kentucky who had complete data in the Vanderbilt Sports Concussion Center outcome registry database of individuals evaluated after sport-related concussion. Patients with attention deficit hyperactivity disorder (ADHD)/learning disability (LD), depression, anxiety, or psychiatric disorder were excluded to limit confounders. The researchers interviewed patients 3 months after initial concussion or until symptoms resolved, up to 1 year after the injury, to obtain demographic, medical history, concussion-related, and insurance information.

White athletes (94%) were more likely to have private insurance and higher median income (56% ≥ 80th percentile) compared with Black athletes (67%, 41% in 0-59th median income percentile). Athletes in zip codes with higher median incomes (60th-79th percentiles compared with lowest income tier) were more likely to return earlier to school (HR 1.506 P =.041).

Symptom resolution occurred at a median 21.0 days (IQR 10.5-61.0 days) for White athletes and a median 12.3 days (IQR 6.8-28.0 days) for Black athletes (P =.026). Multivariable analysis indicated Black athletes reached asymptomatic status more quickly compared with White athletes (HR 1.497 P =.042) and male athletes reached it sooner compared with female athletes (HR 1.508 P =.004).

Returns to school tended to occur after 2 days for White athletes and after 0 days for Black athletes (P =.010). That shorter time association was held through multivariable analysis (HR 1.522 P =.040).

Compared with prior to concussion, White athletes were more likely to report decreases in sleeping (19% vs. 5.6%), doing schoolwork (57.8% vs. 41.7%), and watching television (63.5% vs. 52.8%) compared with Black athletes. In multivariable analysis, Black race was linked with lower odds of reporting activity change after concussion (OR 0.368, P =.049).

Proportionately, Black athletes (including 4 basketball, 4 football, 1 soccer) more often said they changed protective equipment (25.0% vs. 12.3%) compared with White athletes (including 2 basketball, 16 football, 6 soccer), but link between race and sport behavior change was lost after adjusting for age, sex, concussion history, and zip code median income.

Study limitations involved subjective outcome measures and the inability to generalize outside an outpatient concussion center, recall bias, lack of specificity of equipment changes, lack of time interval data between concussion and any previous concussion, and specificity of zip codes to determine median household income.

“Racial differences appear to exist in the outcomes and experience of [sport-related concussion] SRC for young athletes, as Black athletes reached [symptom resolution] SR and return to school sooner than White athletes. Race should be considered as an important social determinant in SRC treatment,” the researchers concluded.

NOCSAE News

View All
  • When Can My Child Start To Play Tackle Football?
    January 25, 2022

    Stack January 20, 2022 The United States has seen a decline in youth and high school football participation in recent years. Many safety concerns have risen, especially when it comes to concussions and head injuries. This concern has led parents, school officials, and other football stakeholders to take a careful look at when it is […]

    Read more
  • Canadian scientists may be on the verge of a reliable test for concussions
    January 25, 2022

    Toronto Star January 21, 2022 It’s been more than a decade since Dr. Charles Tator, the Toronto neurosurgeon, emerged as an authoritative voice of reason in the effort to curtail concussions in sports. And while there’ve been low moments along the way, like the time Tator was swamped with hate mail after he dared call […]

    Read more
  • NFL, Amazon Web Services Create Digital Athlete to Keep Players ‘Left of Boom’ on Injuries
    January 25, 2022

    SportTechie January 21, 2022 The most important football player in the future of the NFL will do anything you ask. This athlete literally runs the same play over and over, millions of times. Requests to wear a new helmet or new cleats are always acceded. Change the venue, the field surface, the weather, even the […]

    Read more

Leave a Reply

Your email address will not be published. Required fields are marked *