School of Kinesiology, Faculty of Health Sciences, Western University, London, ON, Canada.
Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Front Public Health. 2024 Aug 8;12:1430428. doi: 10.3389/fpubh.2024.1430428. eCollection 2024.
Comprising approximately 13.6% of the United States population, Black/African American individuals are overrepresented in sports associated with a high risk of concussion. However, there has been a notable absence of systematic reviews examining whether concussion literature accurately reflects the participation and experiences of Black/African American individuals. Therefore, this study aims to systematically review the prevalence of Black/African American individuals compared to White individuals diagnosed with concussions in the literature.
A systematic search was performed across four electronic databases: PubMed, MEDLINE (Ovid), Scopus and Web of Science. Articles were searched from inception to January 5, 2022. Prevalence data were extracted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis of proportions was conducted within hospital records and national survey data.
Among 447 identified studies, 11 were included, representing 1,839,901 individuals diagnosed with a concussion, with 73.6% identifying as White and 12.5% identifying as Black/African American. The mean proportion of Black/African American diagnosed with a concussion in hospital records (13.9%; 95% CI [12.8, 15.1]) exceeded that in national surveys (6.4%; 95% CI [3.5, 11.3]) but lower than sports-centered studies (16%).
These findings underscore the need to address racial disparities in healthcare within the broader context of social determinants of health and systemic inequities. By identifying gaps in the current research, this study lays the foundation for future investigation aimed at elucidating and addressing healthcare disparities.
黑人/非裔美国人占美国总人口的 13.6%左右，他们在与脑震荡风险较高相关的运动中所占比例过高。然而，一直缺乏系统的综述来检查脑震荡文献是否准确反映了黑人/非裔美国人的参与和经历。因此，本研究旨在系统地综述文献中黑人/非裔美国人与白人个体脑震荡诊断的比例。
在四个电子数据库（PubMed、MEDLINE（Ovid）、Scopus 和 Web of Science）中进行了系统搜索。从创建到 2022 年 1 月 5 日搜索了文章。按照系统评价和荟萃分析的首选报告项目的指南提取患病率数据。对医院记录和全国调查数据进行了比例的荟萃分析。
在 447 项已确定的研究中，有 11 项被纳入，共涉及 1839901 名被诊断为脑震荡的个体，其中 73.6%为白人，12.5%为黑人/非裔美国人。在医院记录中，黑人/非裔美国人被诊断为脑震荡的平均比例（13.9%；95%置信区间[12.8, 15.1]）高于全国调查（6.4%；95%置信区间[3.5, 11.3]），但低于以运动为中心的研究（16%）。
这些发现强调了需要在健康的社会决定因素和系统性不平等的更广泛背景下解决医疗保健中的种族差异。通过确定当前研究中的差距，本研究为未来旨在阐明和解决医疗保健差异的调查奠定了基础。
