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Socioeconomic Disparities in Concussion Presentation.

Daniel J Corwin1,2, Wenshan Li3, Stephen G Fung4

  • 1Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

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|April 22, 2026
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Summary
This summary is machine-generated.

Individuals with higher marginalization markers were more likely to seek concussion care in emergency departments (EDs) and had lower follow-up rates. This highlights disparities in concussion care access and outcomes for vulnerable populations.

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Area of Science:

  • Public Health
  • Health Services Research
  • Epidemiology

Background:

  • Concussion care disparities exist, yet population-level data on marginalization markers is limited.
  • Understanding these associations is crucial for improving healthcare system equity and patient outcomes.

Purpose of the Study:

  • To examine the relationship between socioeconomic measures of disparity and concussion presentation location.
  • To assess the impact of marginalization on concussion follow-up rates.

Main Methods:

  • Population-based cohort study using linked administrative data in Ontario, Canada (2010-2023).
  • Included patients with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada (ICD-10-CA) concussion codes.
  • Assessed patient-level (age, sex, immigrant status, family physician, rurality) and neighborhood-level (income, ON-Marg Index, Household Index, Racialized Populations Index) exposures.

Main Results:

  • Over 674,000 concussion patients were analyzed.
  • Higher marginalization was associated with initial visits to emergency departments (EDs) versus outpatient clinics.
  • Patients initially seen in EDs had significantly lower follow-up rates (28.1% vs 8.7%).
  • Lack of a family physician and higher marginalization were linked to missed follow-up appointments.

Conclusions:

  • Marginalization significantly impacts where patients seek concussion care and their adherence to follow-up.
  • Findings underscore the need for enhanced primary care access, telemedicine, and ED resources to address concussion care inequities.
  • System-wide improvements are necessary to ensure equitable concussion management for all populations.