@article{ref1,
title="Evaluating concussion nondisclosure in college athletes using a health disparities framework and appreciation for social determinants of health",
journal="Journal of athletic training",
year="2021",
author="Wallace, Jessica and Beidler, Erica and Register-Mihalik, Johna K. and Hibbler, Tamaria and Bretzin, Abigail and DeMedal, Spencer and Kerr, Zachary Y.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="CONTEXT: There is limited research concerning the relationship between social determinants of health, including race, healthcare access, socioeconomic status (SES), and physical environment; and, concussion nondisclosure in college-athletes. However, in high school athletes, disparities have been noted, with Black athletes attending under-resourced schools and lacking access to an athletic trainer (AT) disclosing fewer concussions. <br><br>OBJECTIVE: To investigate whether concussion nondisclosure disparities exist by 1) race, 2) SES, and 3) AT healthcare access prior to college; and to understand the differential reasons for concussion nondisclosure between Black and White college-athletes. <br><br>DESIGN: Cross-sectional Setting: College athletics Participants: 735 college-athletes (84.6% White, 15.4% Black) Main Outcome Measures: Participants completed a questionnaire that directly assessed concussion nondisclosure, including reasons for not reporting a suspected concussion. With the premise of investigating social determinants of health, race was the primary exposure of interest. The outcome of interest, nondisclosure, was assessed with a binary (yes/no) question, &quot;Have you ever sustained a concussion that you did not report to your coach, athletic trainer, parent, teammate, or anyone else?&quot; RESULTS: Overall, among White and Black athletes 15.6% and 17.7% respectively reported a history of concussion nondisclosure. No significant differences were found by race for distributions of history of concussion nondisclosure (p=0.57). Race was not associated with concussion nondisclosure when evaluated as an effect modification measure or confounder; and, no significant associations were noted by SES or high school AT access. Differences by race for reported reasons for nondisclosure were found for: &quot;At the time I did not think it was a concussion&quot; (p=0.045) and &quot;I thought my teammates would think I am weak&quot; (p=0.03) with Black athletes reporting these more frequently than White athletes. <br><br>CONCLUSIONS: These data help to contextualize race and its intersection with other social determinants of health that could influence concussion nondisclosure outcomes in college-athletes.<p /> <p>Language: en</p>",
language="en",
issn="1062-6050",
doi="10.4085/1062-6050-0054.21",
url="http://dx.doi.org/10.4085/1062-6050-0054.21"
}