A - 15 Incorporating the Child Opportunity Index and Area Deprivation Index in Sport Concussion Research

Abstract

Social determinants of health, including socioeconomic status (SES) and neighborhood characteristics, are underrepresented in concussion research. We examined two measures of neighborhood advantage and opportunity among patients accessing a multidisciplinary sports concussion clinic in Greater Boston. We collected the Child Opportunity Index (COI) and Area Deprivation Index (ADI) state decile scores and national percentile ranks for all new patients who presented to our clinic in 2023. The COI is an index of neighborhood conditions that may impact childhood development (e.g., education quality, SES, access to healthy food) with ratings from Very Low to Very High. The ADI characterizes an area’s socioeconomic conditions (e.g., income, housing quality, employment, education), with higher scores representing more disadvantage. There were 247 new patients who visited the clinic (Mage = 17.5, SDage = 5.2, 47.8% Girls/Women, 81.4% White, 4.0% Black, 6.5% Asian, 4.9% Hispanic). The majority lived in an area with a High or Very High state COI (74%) and High or Very High national COI (88%). The median ADI state decile was 2.00 (IQR = 1.00–4.00) and the median national percentile was 10.00 (IQR = 5.00–18.00) (representing the highest 10% of advantage). The state deciles for the two measures were correlated (Spearman rho = 0.64), but not redundant. The COI and ADI are important, accessible measures of SES that can be included in future studies. Patients from low SES were greatly underrepresented in the clinic compared to the population of our metropolitan area. Patients were predominantly from higher SES, consistent with prior studies suggesting socioeconomic disparities accessing specialty concussion care.