{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T11:07:07Z","timestamp":1779448027771,"version":"3.53.1"},"reference-count":32,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Headquarters Health Inc"},{"name":"Accorded Actuarial Services"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Mild traumatic brain injuries (mTBIs) are a significant public health concern in the US. Understanding incidence and demographic patterns is essential for developing targeted prevention and intervention strategies. The most recent study using national healthcare records to examine incidence utilized data from 2016, highlighting the need for updated estimates that reflect current trends. Methods: The MarketScan\u00ae Database was used for this study which includes person-specific clinical utilization, expenditures, and enrollment across different services. A query for mTBIs (S06.0x.xx) or post-concussion syndrome (F07.89) from January\u2013December 2023 was performed for patients aged 0\u201364. Patients with the same diagnosis codes for the prior 12 months (i.e., chronic diagnosis), moderate to severe TBIs (S06.2\u20139), skull fractures (S02.xx), and\/or brain hemorrhages (S06.3x) were excluded. Results: Out of 11,737,855 insured members with data in 2023, 43,213 new mTBIs were recorded (incidence rate = 0.37%), with the highest rate in adolescents (incidence rate = 1.27%). From the ages of 0\u201314 years, males had a higher incidence of concussion, but from 15 to 65 years, females had a higher incidence. Minimal differences were seen between urban and rural zip codes. Conclusions: Concussion incidence in adolescents is higher than other age groups, which may reflect increased participation in sports or heightened vulnerability during development. Males had a higher incidence than females during childhood, but females did later in life. These differences may reflect true disparities in injury risk, variations in reporting patterns, or a combination of both. Further research is warranted to understand the underlying mechanisms and to inform age- and sex-specific prevention efforts.<\/jats:p>","DOI":"10.3390\/brainsci16060546","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T10:07:47Z","timestamp":1779444467000},"page":"546","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidences of Concussion in the United States: A Review of Health Insurance Claims"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6961-3958","authenticated-orcid":false,"given":"Alyssa M.","family":"Lickfeld","sequence":"first","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14221, USA"},{"name":"Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY 14215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7883-3668","authenticated-orcid":false,"given":"Elizabeth V.","family":"Castro","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14221, USA"},{"name":"Neuroscience PhD Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava","family":"Ferreira","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14221, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2981-4028","authenticated-orcid":false,"given":"Jazlyn M.","family":"Edwards","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14221, USA"},{"name":"Neuroscience PhD Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alissa","family":"Patel","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14221, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Leddy","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14221, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7190-0004","authenticated-orcid":false,"given":"Mohammad N.","family":"Haider","sequence":"additional","affiliation":[{"name":"UBMD Department of Orthopaedics and Sports Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY 14221, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E60","DOI":"10.1097\/HTR.0000000000000503","article-title":"Increasing incidence of concussion: True epidemic or better recognition?","volume":"35","author":"Langer","year":"2020","journal-title":"J. Head Trauma Rehabil."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Skjeldal, O.H., Skandsen, T., Kinge, E., Glott, T., and Solbakk, A.K. (2022). Long-term post-concussion symptoms. Tidsskr. Nor. Legeforening, 142.","DOI":"10.4045\/tidsskr.21.0713"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S354","DOI":"10.1016\/j.pmrj.2011.07.017","article-title":"Epidemiology of concussion and mild traumatic brain injury","volume":"3","author":"Laker","year":"2011","journal-title":"PM&R"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Foster, C.A., D\u2019Lauro, C., and Johnson, B.R. (2019). Pilots and athletes: Different concerns, similar concussion non-disclosure. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0215030"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1177\/1090198121995732","article-title":"Pluralistic Ignorance as a Contributing Factor to Concussion Underreporting","volume":"49","author":"Baugh","year":"2022","journal-title":"Health Educ. Behav."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1123\/jsr.2019-0419","article-title":"Factors Influencing Concussion Reporting Intention in Adolescent Athletes","volume":"29","author":"Cook","year":"2020","journal-title":"J. Sport Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/00001199-200609000-00001","article-title":"The epidemiology and impact of traumatic brain injury: A brief overview","volume":"21","author":"Langlois","year":"2006","journal-title":"J. Head Trauma Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e20154635","DOI":"10.1542\/peds.2015-4635","article-title":"Sports- and Recreation-Related Concussions in US Youth","volume":"138","author":"Bryan","year":"2016","journal-title":"Pediatrics"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1080\/02699052.2016.1199898","article-title":"Thirty-day re-admission after traumatic brain injury: Results from MarketScan\u00ae","volume":"30","author":"Canner","year":"2016","journal-title":"Brain Inj."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e2023065484","DOI":"10.1542\/peds.2023-065484","article-title":"Early Childhood Concussion","volume":"154","author":"Beauchamp","year":"2024","journal-title":"Pediatrics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/MLR.0000000000001511","article-title":"Costs of Nonfatal Traumatic Brain Injury in the United States, 2016","volume":"59","author":"Miller","year":"2021","journal-title":"Med. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1007\/s00247-023-05633-6","article-title":"Neuroimaging for mild traumatic brain injury in children: Cross-sectional study using national claims data","volume":"53","author":"Waltzman","year":"2023","journal-title":"Pediatr. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2325967116662458","DOI":"10.1177\/2325967116662458","article-title":"The rise of concussions in the adolescent population","volume":"4","author":"Zhang","year":"2016","journal-title":"Orthop. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S69","DOI":"10.1097\/JSM.0000000000000594","article-title":"Factors associated with self-reported concussion history in middle school athletes","volume":"30","author":"Terry","year":"2020","journal-title":"Clin. J. Sport Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Cook, N.E., and Iverson, G.L. (2021). Concussion Among Children in the United States General Population: Incidence and Risk Factors. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.773927"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1080\/02699052.2022.2034954","article-title":"Gaps in concussion management across school-aged children","volume":"36","author":"Snedaker","year":"2022","journal-title":"Brain Inj."},{"key":"ref_17","unstructured":"Hansen, L.G., and Chang, S. (2012). White Paper: Health Research Data for the Real World: The MarketScan Databases, Truven Health Analytics."},{"key":"ref_18","unstructured":"US Bureau (2024). Nation\u2019s Urban and Rural Populations Shift Following 2020 Census, US Bureau."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Walker, K. (2023). Analyzing US Census Data: In Methods, Maps, and Models in R, Chapman and Hall\/CRC.","DOI":"10.1201\/9780203711415"},{"key":"ref_20","first-page":"245","article-title":"Demographic categories revisited. Age categories and the age of the categories","volume":"Volume 5","author":"Bourdelais","year":"2006","journal-title":"Human Clock: The Bio-Cultural Meanings of Age"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/s40798-025-00834-9","article-title":"The Incidence of Sports-Related Concussion in Children and Adolescents: A Systematic Review and Meta-Analysis","volume":"11","author":"Ingram","year":"2025","journal-title":"Sports Med.-Open"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1001\/jama.2021.1538","article-title":"Trends in the prevalence of concussion reported by US adolescents, 2016-2020","volume":"325","author":"Veliz","year":"2021","journal-title":"JAMA"},{"key":"ref_23","first-page":"71","article-title":"Concussion: Mechanisms of injury and trends from 1997 to 2019","volume":"103","author":"Reid","year":"2020","journal-title":"Rhode Isl. Med. J."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Biegon, A. (2021). Considering biological sex in traumatic brain injury. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.576366"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1080\/1750984X.2020.1824243","article-title":"Under-reporting of sport-related concussions by adolescent athletes: A systematic review","volume":"16","author":"McKenzie","year":"2023","journal-title":"Int. Rev. Sport Exerc. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1007\/s11910-021-01160-9","article-title":"Management of Concussion and Persistent Post-Concussive Symptoms for Neurologists","volume":"21","author":"Leddy","year":"2021","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport\u2014The 5th international conference on concussion in sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","journal-title":"Br. J. Sports Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"463","DOI":"10.4103\/2249-4863.192376","article-title":"Understanding health seeking behavior","volume":"5","author":"Oberoi","year":"2016","journal-title":"J. Fam. Med. Prim. Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12982-015-0031-x","article-title":"Children and youth with \u2018unspecified injury to the head\u2019: Implications for traumatic brain injury research and surveillance","volume":"12","author":"Chan","year":"2015","journal-title":"Emerg. Themes Epidemiol."},{"key":"ref_30","first-page":"31","article-title":"Accuracy of mild traumatic brain injury case ascertainment using ICD-9 codes","volume":"13","author":"Bazarian","year":"2006","journal-title":"Acad. Emerg. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1080\/02699050400013568","article-title":"Validity of administrative data for characterizing traumatic brain injury-related hospitalizations","volume":"19","author":"Shore","year":"2005","journal-title":"Brain Inj."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"i13","DOI":"10.1136\/injuryprev-2019-043517","article-title":"Multisite medical record review of emergency department visits for unspecified injury of head following the ICD-10-CM coding transition","volume":"27","author":"Peterson","year":"2021","journal-title":"Inj. Prev."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/6\/546\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T10:35:41Z","timestamp":1779446141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/6\/546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":32,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["brainsci16060546"],"URL":"https:\/\/doi.org\/10.3390\/brainsci16060546","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]}}}