Concussion diagnosis rates rise as awareness grows

Concussion diagnosis rates are rising among teenagers—and researchers think they know why. It might not be that more kids are actually getting hurt, but that coaches, parents and doctors are more aware of the warning signs of adolescent head injuries.

A Blue Cross Blue Shield report from Sept. 27 included concussion info from nearly a million concussion health insurance claims. The report shows that concussion diagnoses for kids aged 10 to 19 increased 71 percent between 2010 and 2015. Boys saw a 48 percent increase and girls saw a 118 percent increase—though teenage boys are still more likely to suffer a concussion (17 injuries per 1,000 boys and 13.3 injuries per 1,000 girls). The incidence of post-concussion syndrome also increased—12.4 percent of people in that age group were diagnosed in 2015.

The researchers point out that new state “shake it off” laws were created specifically to address head injuries among this age group—many states now require student athletes to get an official medical all-clear before re-joining a game after a potential brain injury. (Plus, people that age are more likely than younger children or older adults to be participating in activities that could lead to concussions.)

Concussions appeared to be especially high in certain states and lower in others: Much of the Northeast, plus Pennsylvania, New Jersey and Colorado had 22 or more 10- to 19-year-olds diagnosed with concussion per 1,000 of their peers in 2015. But states such as Florida, Georgia, Kentucky, Nevada had fewer than 10 per 1,000 in 2015. Nearly every state saw some kind of relative increase.

Blue Cross Blue Shield CMO Trent Haywood, MD, JD, said in a statement that the report shows awareness of concussion dangers are growing—but the state variability shows some places might still be lagging behind.

“The study shows that there is more awareness about the seriousness of concussions and that younger individuals are receiving more care for these injuries than in the past,” Haywood said.

The diagnoses spiked in the fall, especially among males. About seven per 1,000 males aged 10 to 19 receive a concussion diagnosis in the fall, compared to a low of 2.9 in the summer. About 3.7 per 1,000 girls are diagnosed with a concussion in the fall with a summertime low of about 1.9 per 1,000 females in the same age group.

That could be because fall is when soccer and football are usually in season in U.S. schools and recreational leagues. Football, in particular, helped lead to the growing concussion discussion with the emergence of chronic traumatic encephalopathy diagnoses.

Further evidence that youth sports schedules are contributing to kids’ concussions is that the same seasonal variability was not found in concussion diagnoses in adults 20 to 64. Rates among adults still increased from 2010 to 2015, but only about 26 percent, from 8.9 people per 1,000 people in 2010 to 15.2 per 1,000 people in 2015. Also, the rates remained steady throughout the year.

In contrast to the trends among kids, however, the adults 20 to 64 were more likely to experience post-concussion syndrome than those aged 10 to 19. The incidence of post-concussion syndrome diagnosis after concussion among 20 to 64-year-olds was 15.7 percent in 2015.

The Blue Cross Blue Shield report called for more research to understand why there is such a variability among concussion diagnosis rates among the states and how their individual regulations and laws can influence kids’ (and adults’) health when it comes to concussions.