Medical Student Vanderbilt University School of Medicine
Introduction: Sport-related concussion (SRC) is an evolving public health concern, especially among youth athletes. Despite emerging evidence that race/ethnicity are important factors in determining concussion outcomes, studies examining race/ethnicity are limited. We conducted a systematic review to: 1) determine the prevalence of SRC studies that report race/ethnicity of their participants, 2) describe how race/ethnicity are used within each study, and 3) assess predictive factors for reporting of race/ethnicity.
Methods: PubMed/Embase/PsycINFO/CINAHL databases were queried for all primary SRC literature related to the diagnosis, treatment, or recovery of SRC in athletes between ages 5-25 with the sample size ≥ 25. The search was performed 03/2021 and included only studies published after 03/2013, which marked the 4th International Conference on Concussion in Sport.
Results: Of 4,583 studies screened, 854 articles met inclusion criteria. Of the included articles, 132 (15.5%) reported the sample’s race and 65 (7.6%) reported ethnicity, whereas 721 (84.4%) reported neither. When examining the demographic characteristics of the 132 studies that reported race, 69.8% of athletes were reported to be White. Additionally, 79.5% of these studies solely used race as a demographic descriptor, as opposed to examining it as a primary variable of interest. Studies published more recently were more likely to report race. Further, specific study/journal topics and geographic location of the authors were more likely to report race.
Conclusion : Over the past decade, 15.5% of all included sports concussion articles reported race and 7.6% reported ethnicity. White race represented 69.8% of the total sample size, and race was most commonly used as a demographic descriptor. Future studies should improve the reporting of race/ethnicity, diversify study samples by focusing on enrolling athletes from underrepresented groups, and consider the potential impact of race/ethnicity as social determinants of health on risk factors, recovery, and long-term sequelae after SRC.
