Social factors matter: An upcoming study supporting underrepresented NCAA student-athletes with a concussion

February 14, 2023


By Adrian Boltz

Center members have been intentionally looking at ways to improve our understanding of concussion among historically under-represented individuals. Harnessing the University of Michigan’s involvement and leadership in the Concussion Assessment, Research, and Education (CARE) Consortium, Center director Dr. Steven Broglio, former PhD student and current Assistant professor at the University of New Mexico, Dr. Allyssa Memmini, and PhD student Adrian Boltz utilized a CARE dataset to examine how National Collegiate Athletic Association (NCAA) student-athletes’ race intersects with their household income, participation in different collegiate sports, and their journey returning to the classroom and the sports after sustaining a sports-related concussion (SRC).  NCAA student-athletes have a known concussion risk, highest in sports with high head/body contact bouts, and may be vulnerable to SRC mismanagement.

Current SRC management guidelines advocate for individualized care to assist injured student-athletes returning to their classroom and the sport they played. However, NCAA student-athletes are uniquely burdened after sustaining an SRC, given their expectation to maintain high athletic and academic standards. A sports-related concussion can derail one, if not both. 

To promote equitable access to health care and resources supporting historically underrepresented NCAA student-athletes, these center members strove to understand all factors associated with SRC, from its clinical presentation to recovery. One of the strategies proposed is to examine the injury through a biopsychosocial lens – meaning to carefully consider all the factors, including what’s happening at the cellular level when injuries occur (biology), how the patient thinks about this injury (psychology), and other social factors that may impact how likely one is exposed to the injury risks and how one recovers (sociology). Even though the scientific community has extensively studied biological and psychological factors, social determinants have not been examined to a comparable degree. 

“NCAA student-athletes are uniquely burdened after sustaining an SCR, given their expectation to maintain high academic and athletic standards. A sports-related concussion can derail one, if not both.”

Adrian J. Boltz, MSH
PhD student, Movement Science, School of Kinesiology

Such a gap calls the group’s attention to social factors impacting SRC recovery among NCAA athletes. Race is the first social construct of interest, given it can carry implicit bias for healthcare providers and inevitably influence post-injury management. If not managed correctly, such bias can negatively affect a patient’s acute and long-term quality of life. In addition to race, socioeconomic status also influences how an SRC impacts an NCAA student-athlete. For instance, a temporary suspension from the game due to a concussion may be particularly formidable for student-athletes who see NCAA athletics as an opportunity to significantly improve their (and their families’) financial and social well-being. Access to sports and higher education remains predicated by household income. These social factors are important for healthcare providers to consider as a part of their concussion treatment and management strategies, especially when supporting an underrepresented NCAA student-athlete’s journey returning to their classroom and sport.