The Effect of Social Disadvantage on Initial Sport-Related Concussion Evaluation Times in 13 to 17-Year-Old Athletes

To evaluate the influence of social disadvantage on time to presentation to care after sport-related concussion (SRC).

Retrospective cohort study.

The study was conducted using a REDCap database of former patients treated at a regional sports concussion clinic.

Athletes 13 to 17-year-old, who sustained an SRC and were examined at the regional sports concussion clinic between 11/2017 and 04/2022.

Area Deprivation Index (ADI) score was calculated using the patient's zip codes.

Time to present to a regional sports concussion clinic (days) and time to present to any healthcare setting (days). χ2 analysis and logistic regression assessed for differences between ADI quartiles and predictors of time to presentation, respectively.

A total of 916 patients were included (mean age = 15.8 ± 1.3). The median time to presentation to any healthcare setting was 2 days (IQR: 0-6). Highest ADI quartile patients (ie, most socially disadvantaged) were more likely to be Hispanic/Latino (P = 0.003), non-White (P < 0.001), public school attendees (P < 0.001), and have had nonprivate insurance (P < 0.001). These patients also took longer to present to a regional sports concussion clinic (P < 0.001) compared with lower ADI quartiles. ADI score (B = 0.095, P < 0.001) and family history of migraines (B = 0.177, P = 0.006) significantly predicted longer times to clinic presentation.

Greater social disadvantage was associated with a longer time to present to concussion specialty care. Ensuring those with fewer resources have early access to sports concussion care represents an actionable opportunity to reduce this healthcare disparity.

Social determinants of health may be barriers to timely and equitable access to specialty concussion care.