Neighborhood Conditions Shape How Children Recover from Concussions, New Research from CIC Shows

New research from a CIC-funded study on pediatric concussion recovery shows that children who experience concussions and live in neighborhoods with a lower Childhood Opportunity Index (COI) may experience a longer recovery process for their concussions. Lower neighborhood opportunity was associated with greater symptom burden, reduced likelihood of seeing a concussion specialist or any healthcare provider for follow up after injury, and increased family strain after concussion.

How they analyzed the data

The research team, led by Danny Thomas, MD, MPH, professor of pediatrics at MCW and medical staff president and pediatric emergency medicine research director at Children’s Wisconsin, conducted a secondary analysis of a multi-center randomized trial of four concussion treatments. They stratified the children included in the data by COI – a measure of community-level educational, health, and economic resources – into low, middle, or high groups and then looked at outcomes including demographics, injury characteristics, Post Concussion Symptom Scale scores through two months, return to sport, follow-up within 14 days, healthcare specialty utilization, missed workdays, childcare days, and parental perceptions.

Detailed results

From the analysis, the results showed that within the study’s patient population, Black and Hispanic families and those insured by Medicaid were more likely to reside in lower COI communities. Children from lower COI neighborhoods were more likely to go to an emergency department for treatment following concussion and had higher symptom scores at 14 days, meaning they were experiencing more symptoms than children from middle and high COI neighborhoods two weeks after injury. They were also less likely to have returned to sports by one month after injury, have a follow-up medical appointment with any healthcare provider within 14 days, or be seen by sports medicine concussion specialists. Families of children in these groups reported more missed work and childcare days. Low COI was also independently associated with reduced follow-up and greater family burden.

Why this matters

The results of this study show that where a child lives plays an important role in how they recover from concussions. The long-term impacts of concussion injuries are felt throughout nearly every facet of a person’s life, so improving access to care and support systems is essential for equitable health outcomes.

To learn more about the study, contact Dr. Thomas at dthomas@mcw.edu.