Trends in Adolescent Sports-Related Concussions: Analysis of the Youth Risk Behavior Surveillance System (YRBSS)

Background and/or Objectives: Sports-related concussions (SRCs) among adolescents pose public health concerns related to long-term cognitive, physical, and emotional consequences. Identifying demographic disparities and associated risk factors is essential for effective concussion prevention, management, and policy development. This study examines trends in SRC prevalence and disparities in concussion reporting based on sex, race/ethnicity, grade level, and sports participation among adolescents using Youth Risk Behavior Surveillance System (YRBSS) data from 2017 to 2023.

Design: Cross-sectional study using YRBSS data from 2017–2023.

Setting : Nationally representative school-based survey.

Participants : A total of 55,347 adolescents (grades 9–12) with available data on concussion history, sex, race/ethnicity, and sports participation.

Interventions: Not applicable.

Main Outcome Measures: Self-reported history of SRCs, categorized as none (0) vs. one or more (≥1) concussions. Secondary measures included demographic variables (sex, race/ethnicity, grade) and sports participation.

Results: Analysis revealed differences between sexes; males were significantly more likely than females to report concussions (OR = 1.21; p < 0.001). Among respondents, Asian adolescents reported significantly fewer concussions than White adolescents (OR = 0.84; p = 0.011). Higher grade levels were associated with lower concussion reporting (OR = 0.94; p < 0.001). Greater sports participation was strongly associated with increased concussion risk (OR = 1.28; p < 0.001).

Conclusions: Significant disparities exist in adolescent concussion reporting based on sex, race/ethnicity, and grade level, with higher sports participation increasing concussion risk. Findings showed significant reporting differences between racial/ethnic groups, which may reflect differences in reporting behavior, symptom recognition, or sports participation. Higher grade levels were associated with lower reporting, potentially influenced by return-to-play pressures or sport attrition. These findings highlight the need for targeted educational and preventive interventions, particularly among younger male athletes and groups with lower reporting. Clinicians should address barriers to accurate concussion reporting through culturally sensitive education and targeted screening, especially for older adolescent male athletes and racial/ethnic groups prone to underreporting.