{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:43:34Z","timestamp":1792511014789,"version":"4.5.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Child Neurol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>\n                    We examined the association between social determinants of health and the likelihood of sustaining a concussion among adolescents. Participants in this cross-sectional study were 7164 high school students who completed the 2021 Adolescent Behaviors and Experiences Survey (52.7% girls; mean age\u2009=\u200916.0 years, SD\u2009=\u20091.2; age range 12-18 years). Logistic regression was used to determine which social determinants of health variables were associated with a self-reported history of concussion from playing a sport or being physically active over the past year. One in 10 adolescents (n\u2009=\u2009716; 10.0% total; 11.8% of boys, 8.3% of girls) reported sustaining a concussion during the past year. Seven of 10 adolescents (70.3%) reported experiencing at least 1 of 8 negative social determinants of health. A multivariable logistic regression was statistically significant (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001), indicating that the negative social determinants of health were associated with having sustained a concussion during the past year; the model explained 12.5% (Nagelkerke\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    ) of the variance in concussion. Controlling for all other predictors, sports participation (odds ratio [OR]\u2009=\u20093.72, medium effect), housing instability (OR\u2009=\u20093.25, small-medium effect) and limited English language proficiency (OR\u2009=\u20093.05, small-medium effect) were the strongest independent predictors of sustaining concussion within the past year. Adolescents who lived in a neighborhood where there is violence (OR\u2009=\u20091.78, small effect), who were bullied (OR\u2009=\u20091.57, very small effect), and who experienced food insecurity (OR\u2009=\u20091.36, very small effect) were more likely to have sustained a concussion. Research is needed to understand the nature of these determinant-injury associations. Whether social determinants of health are associated with specific treatment and rehabilitation needs, and time to recover following concussion, should be examined with prospective studies.\n                  <\/jats:p>","DOI":"10.1177\/08830738241304867","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T10:18:07Z","timestamp":1737109087000},"page":"278-290","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Association Between Social Determinants of Health and Concussion Among High School Students in the United States"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1946-9023","authenticated-orcid":false,"given":"Nathan E.","family":"Cook","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA"},{"name":"Mass General for Children Sports Concussion Program, Boston, MA, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles E.","family":"Gaudet","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA"},{"name":"Mass General for Children Sports Concussion Program, Boston, MA, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant L.","family":"Iverson","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA"},{"name":"Mass General for Children Sports Concussion Program, Boston, MA, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.810361"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.19934"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.2374"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.12.037"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2021.03.008"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.01.048"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2018.11.005"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2021.0019"},{"issue":"780278","key":"e_1_3_2_10_2","first-page":"1","article-title":"Lifetime history of concussion among youth with ADHD presenting to a specialty concussion clinic. 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Front Neurol. 2021;12(773927):1-6. doi:https:\/\/doi.org\/10.3389\/fneur.2021.773927","journal-title":"Front Neurol."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.11.003"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000673"},{"key":"e_1_3_2_18_2","unstructured":"US Department of Health and Human Services Office of Disease Prevention and Health Promotion. Healthy People 2030. Accessed March 9 2021 https:\/\/health.gov\/healthypeople\/objectives-and-data\/social-determinants-health"},{"key":"e_1_3_2_19_2","unstructured":"US Department of Health and Human Services Office of Disease Prevention and Health Promotion. Healthy People 2020. 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