Peer-reviewed article
The Social Determinants of Health in Pediatric Concussion: A Scoping Review.
Ramsay S, Ramsay S, Harasym JA, Liu B, Lloyd H ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined how social determinants of health affect concussions in children and adolescents in North America. The authors reviewed 26 peer-reviewed studies published between 2005 and 2025, categorizing findings into identification, service access, and outcomes. The review found that lower socioeconomic status, limited English proficiency, and housing instability are linked to higher concussion rates, while non-White children and rural residents face barriers to specialized care. The authors identify gaps in research and call for better representation and understanding of health disparities in concussion care for young people.
Key points
- Lower socioeconomic status, limited English proficiency, and housing instability were associated with higher incidence of concussions in children
- Non-White pediatric patients, those with public insurance, and rural residents were more likely to use emergency departments rather than specialized concussion services
- Non-White participants often had shorter recovery times, while the relationship between socioeconomic status, public school attendance, and recovery duration was inconsistent
- Current literature shows gaps in representation of diverse populations in concussion research
- There are documented disparities in access to concussion care and treatment outcomes across different social groups
Limitations
This scoping review synthesizes existing literature rather than collecting new primary data, so findings are limited by the quantity and quality of studies already published. The review does not establish causation for the associations identified, and the inconsistent findings on recovery times suggest the evidence base itself may be incomplete or methodologically diverse.
Abstract
Introduction In North America, concussions are a common injury in the pediatric population. Much of the research to date has focused on biological aspects of concussion. Consideration of psychological, social and ecological factors, specifically the social determinants of health (SDH), relevant to concussion is essential to advancing the field of pediatric concussion. Objectives Using the WHO Conceptual Framework for Action on the Social Determinants of Health, we performed a scoping review to (1) identify and describe the research areas studied in the literature on SDH and pediatric concussion, and (2) summarize the reported findings of the included studies. Methods A comprehensive search for peer-reviewed articles published between 2005 and 2025, was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Review (PRISMA-ScR) guidelines. Selected studies were reviewed for descriptive analysis by two independent reviewers. Results In total, 26 studies were included in this scoping review and the topics of study were grouped into 3 main categories: (1) identification; (2) service access and utilization; and (3) outcomes. Lower socioeconomic status (SES), limited English proficiency, and housing instability were linked to a higher incidence of concussions. Non-White pediatric patients, those with public insurance, and rural residents were more likely to use emergency departments instead of specialized concussion services. Non-White participants often had shorter recovery times, while the connections between socioeconomic status, public school attendance, and recovery duration were inconsistent. Conclusion The findings illustrate current gaps in the literature and opportunities for actions to address SDH among children and adolescents to improve representation in concussion research, understand differences in concussion reporting and tracking and learn about and mitigate disparities in access to concussion care and treatment outcomes.