Racial identity and concussion diagnosis and recovery trajectories in collegiate athletes: a LIMBIC MATARS investigation

ABSTRACT

Objective

To determine if there were concussion diagnosis and recovery disparities between collegiate athletes with Black and White racial identities.

Design

Retrospective cohort study.

Methods

Concussion information was extracted from NCAA athlete medical files at LIMBIC MATARS member institutions from the 2015–16’ to 2019–20’ academic years. A total of 410 concussions from 9 institutions were included that provided all independent (i.e. racial identity of Black or White) and dependent variable information (i.e. dates of injury, diagnosis, symptom resolution, and return to sport) that were analyzed using Mann-Whitney U tests. The sample consisted of 114 (27.8%) concussions sustained by Black athletes and 296 (72.1%) sustained by White athletes.

Results

The overall sample had a median of 0 days between injury occurrence to diagnosis, 7 days to symptom resolution, and 12 days to return to sport. No significant timing differences were observed for concussion diagnosis (p = .14), symptom resolution (p = .39), or return to sport (p = 0.58) between collegiate athletes with Black versus White racial identities.

Conclusions

These findings may reflect equitable access to onsite sports medicine healthcare resources that facilitate concussion management in the collegiate sport setting. Future work should explore these associations with a larger and more diverse sample of collegiate athletes.

KEYWORDS:

• Brain injury
• college sports
• health disparity
• injury recovery
• social determinants of health

Acknowledgments

We thank the athletic trainers, athletes, and student researchers that supported our collaborative research endeavors. The authorship would also like to acknowledge the contributing LIMBIC MATARS site investigators: Michelle Kirk, M.D. and David Gable, ATC (Texas Christian University), Brett Mortensen, Ph.D. (Brigham Young University), James Day, Ed.D. (Augustana University), Allison Peplowski (University of South Dakota), Kristin Wilmoth, Ph.D. and C. Munro Cullum, Ph.D. (The University of Texas Southwestern Medical Center), Tom Campbell, M.S. (Old Dominion University), Sean Ahonen, ATC (Virginia Union University), Verle Valentine, M.D. (Sanford Health), Kate Higgins, Psy.D. and Heather Bouchard, M.A. (University of Nebraska), Jessica Gill, Ph.D. (Johns Hopkins University), Daniel Rosenblum, M.Ed., Donna Broshek, Ph.D., and Rachel Smetana, Ph.D. (University of Virginia), Tenesha Helm (Lynchburg University), Jessie Oldham, Ph.D. (Virginia Commonwealth University).

Disclosure statement

Drs. Erica Beidler, Patricia M. Kelshaw, Jessica Wallace, Michael J. Larson, Thayne A. Munce, Thomas G. Bowman, Meredith N. Decker, Samuel R. Walton, Nyaz Didehbani, and David X. Cifu have no declarations of interest related to this work. Additionally, Catherine C. Donahue has nothing to declare. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Jacob E. Resch has received funding from the Medical Technology Enterprise Consortium.

Additional information

Funding

Dr. Monique R. Pappadis’ contributions to this work were supported under grants from the National Institute on Aging [NIA grant number K01AG065492] and the National Institute on Minority Health and Health Disparities [NIMHD contract number L60MD009326L].