Emergency department visits for pediatric concussion by material deprivation, age, and sex, in Ontario, Canada, 2010-2020: a population-based study

Background/aims — Concussion has been a topic of concern in Ontario, Canada and elsewhere, and new research and guidelines are emerging. The association between material deprivation and ED visits for concussions is not well-established, and many studies have focused on organized sports which may not be equally accessible. The objective of this study was to examine the association between material deprivation, age, sex, and ED visits for concussions in children and youth (0-19).

Methods — This study used administrative data from ICES in Ontario, Canada. All ED visits for children and adolescents with ICD-10 (International Classification of Disease version 10) S060 are included. The denominator was the number of children residing in Ontario. Incidence rate per 100,000 and 95% confidence intervals were calculated.

Results — The ED visit rate per 100,000 children and adolescents varied by year, material deprivation, age, and sex. Rates among children with the greatest material deprivation (Quintile 5) were 36.7 in 2010 and 43.3 in 2020, while the corresponding rates in the lowest quintile were 62.6 and 61.8. The ED visit rate was increasing prior to the pandemic in 2020.

Conclusions — Children in a lower material deprivation quintile consistently visited EDs for concussion more frequently than children from higher quintiles. Children in less deprived areas may be more able to participate in organized sports and more aware of concussion policies such as Rowan’s law which requires medical care following a suspected sport-related concussion. Resources related to awareness and identification of concussions should be considered for all children and youth.