P3.142: Sociodemographic Disparities in Self-Reported Lifetime History of Pediatric Concussion

Background: Pediatric concussion is a growing national public health problem, with up to 24% of adolescents reporting a lifetime history of concussion. However, little is known about how sociodemographic factors such as race, ethnicity, and language impact lifetime concussion prevalence.

Methods: We conducted a cross-sectional analysis of 2023 data from the National Survey of Children’s Health (NSCH), which is administered annually to caregivers of children ages 0-17 years residing in the United States via mail and web-based methods in English and Spanish. The primary outcome for our study was self- or parent-reported lifetime history of concussion or brain injury (“Do you think this child has EVER had a concussion or brain injury?”). We also extracted data on child sociodemographics and medical history, household characteristics, parent and family characteristics, and healthcare access. Frequencies were stratified by lifetime history of concussion or brain injury and weighted for sample representativeness. We utilized survey-weighted logistic regression to calculate unadjusted and adjusted odds ratios (aOR).

Results: A total of 55,162 surveys were completed for the year 2023. Of these, 54,917 (representing 71,754,397 children in the United States) answered questions about concussion, and 2,624 (representing 2,858,755 children in the United States, or 4.0%) reported a lifetime history of concussion. In adjusted analysis, lower odds of reported lifetime concussion were associated with female sex (aOR 0.68, 95% CI [0.58–0.81]), Black or African American (0.61, [0.41–0.91]) or Asian race (0.4, [0.27–0.61]) compared to White race, Hispanic ethnicity (0.75, [0.59–0.96]), non-English as the primary household language (0.5, [0.29–0.86]), and parent high school education level (0.66 [0.51, 0.85]) compared to more than high school. Unadjusted and adjusted odds ratios for all covariables are presented in Table 1.

Conclusion: Reported lifetime history of concussion is significantly lower among Black and Asian children and those living in non-English speaking households. These findings raise important questions about whether lower reported rates of concussion reflect true differences in incidence or potential disparities in recognition, care-seeking, or diagnosis. Further study is needed to investigate these possibilities and to clarify how sociodemographic factors shape reporting and recognition of pediatric concussion. Findings may inform future efforts to improve equity in concussion education and awareness, particularly in racially and linguistically diverse populations.