B-148: Examining Associations Between Social Determinants of Health and Sustaining a Concussion in Adolescents in the United States
Abstract
Objective: Social determinants of health (SDoH) are environmental and socioeconomic factors that influence adolescent health and wellbeing. SDoH are understudied in relation to concussion risk and outcomes in children and adolescents. We examined whether SDoH relating to lower socioeconomic status, health literacy, and access to healthcare were associated with increased risk for past-year concussion in a national sample of adolescents from the United States. Method/Data Selection: 15,352 adolescents aged 14-18 completed the Youth Risk Behavior Survey in 2023 and met the inclusion criteria. Students were asked: ‘During the past 12 months, how many times did you have a concussion from playing a sport or being physically active?’ and responses were coded as yes or no. Multivariate logistic regression examined associations between SDoH, demographic variables, and past-year concussion. Results/Data Synthesis: 14.8% of participants reported experiencing a concussion in the past year (16.4% boys; 13.2% girls). Statistically significant predictors of greater past-year history of concussion included sports participation (Odds Ratio[OR]=3.27), limited English language proficiency (OR=2.91), housing instability (OR=1.79), limited parental supervision (OR=1.69), feeling unsafe going to school (OR=1.51), neighborhood violence (OR=1.51), being bullied (OR=1.33), having basic needs not met (OR=1.33), and male sex (OR=1.32). Conclusions: Several adverse SDoH were associated with a higher past-year concussion history among adolescents in the United States. Socioeconomic status, neighborhood conditions and safety, parental supervision, healthcare access, and health literacy are key factors to consider in studies of concussion risk. SDoH also serve as valuable variables for future research aimed at promoting equitable access to high-quality assessment, treatment, and rehabilitation services for concussion.