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The Underreporting of Concussion: Differences Between Black and White High School Athletes Likely Stemming from Inequities

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Abstract

Previous studies have found that Black high school athletes have poorer knowledge about concussions and have fewer sports medicine healthcare resources than White athletes, but research on concussion disclosure by race is still needed. Therefore, the purpose of this study was to examine racial differences in concussion reporting behaviors between Black and White high school athletes. This cross-sectional study administered surveys to 577 high school athletes (64.5% Black; 72.3% males; 16.02 ± 1.2 years) from 14 schools (title I, n = 9; non-title I, n = 5). The survey included self-reported items on concussions and bell-ringers experienced during games and practices and the number of these episodes that were reported to an authoritative figure. Reasons for reporting and not reporting were also assessed. Results found that White athletes were more likely to recall experiencing a bell-ringer in games compared with Black athletes. They were also more likely to report a bell-ringer or concussion that occurred in a game. There was a significantly higher proportion of Black athletes compared with White athletes that did not report their bell-ringer experienced in games and concussions experienced in practices. White athletes were more likely than Black athletes to disclose a concussion because they thought they had a concussion, while there were no racial differences in the reasons for not reporting. The findings of this study highlight the critical role that race, as a social determinant of health, may play in concussion reporting in high school athletes. Future public health efforts should seek to further understand and overcome inequities in healthcare resources for concussion education and management.

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Funding

This research endeavor was supported by the Blue Cross Blue Shield of Michigan Foundation, the Pentacost Foundation, and the Michigan State University College of Education.

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Authors and Affiliations

  1. Department of Health Science, University of Alabama, 270 Kilgore Lane, 2106 Capital Hall, Tuscaloosa, AL, 35487, USA

    Jessica Wallace, Danae Delfin & Haleigh Gray

  2. Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania, Blockley Hall Room 937, 423 Guardian Drive, Philadelphia, PA, 19104-6021, USA

    Abigail Bretzin

  3. Department of Athletic Training, Duquesne University, 600 Forbes Avenue, 118 Health Sciences Building, Pittsburgh, PA, 15282, USA

    Erica Beidler

  4. Department of Kinesiology, Athletic Training, Michigan State University, East Lansing, MI, 48840, USA

    Tamaria Hibbler & Tracey Covassin

Authors
  1. Jessica Wallace
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  2. Abigail Bretzin
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  3. Erica Beidler
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  4. Tamaria Hibbler
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  5. Danae Delfin
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  6. Haleigh Gray
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  7. Tracey Covassin
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All authors contributed to one or more components of this research publication.

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Correspondence to Jessica Wallace.

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Ethical approval was obtained through the Institutional Review Board at Michigan State University. Our research has been approved and been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Wallace, J., Bretzin, A., Beidler, E. et al. The Underreporting of Concussion: Differences Between Black and White High School Athletes Likely Stemming from Inequities. J. Racial and Ethnic Health Disparities 8, 1079–1088 (2021). https://doi.org/10.1007/s40615-020-00864-x

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  • DOI: https://doi.org/10.1007/s40615-020-00864-x

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