Study finds geographic variations in concussion diagnoses across U.S. emergency departments

Researchers in Michigan State University's Department of Kinesiology found significant geographic variations in concussion diagnoses in United States emergency departments -; with the highest rates in the South and lower rates in the Midwest and Northeast.

The study, published by the Journal of Safety Research, analyzed a public database of emergency department visits from 2010 to 2018, focusing on sport-related concussions, or SRC, and nonsport-related concussions, or NSRC.

The study authors, from MSU's College of Education and the University of Pittsburgh, found over 1,150 emergency department visits were due to concussions, which equates to more than 7 million visits nationwide, according to the probability sampling method used.

Regional differences

In terms of the regional differences, the South's frequency of concussion diagnoses in emergency departments was the highest, which could be attributed to the region's high population density.

Additionally, the research notes that regional differences in health care utilization might contribute to the higher number of reported concussions in the South and the lower odds of concussions diagnosed in the Midwest and Northeast.

Our findings highlight not only the disparities in concussion diagnoses across different regions but also emphasize the need for tailored public health strategies to address these variations effectively. There are several factors we couldn't examine in this study, but our findings give us new ideas to explore further and understand why these results are happening."

Aaron Zynda, study's first author and Department of Kinesiology Doctoral Program graduate

Mechanism differences

A key factor related to concussions and diagnosis is health care access.

"Where are people going to get treated for a concussion?" said MSU Assistant Professor Alyssa Pollard-McGrandy, who also graduated from the Kinesiology Doctoral Program. "Depending on where you are and what you do for a job and what type of insurance you have -; these factors and care-seeking behaviors all come into play."

Another key factor is whether concussions were caused from sports contexts. Interestingly, 94.3% of concussions based on the study were caused by nonsport-related mechanisms, such as motor vehicle accidents and falls.

According to Zynda, there is a need for additional research and broader awareness efforts beyond the sports context, as NSRCs impact a significantly larger portion of the population.

The researchers say that while legislation over the last decade has focused on the management of SRCs, the higher occurrence of less-addressed NSRCs calls for similar policy attention to enhance prevention and treatment efforts.