A - 22 Social Determinants of Health and Parent-Reported Concussion History in Children and Adolescents With ADHD

Abstract Purpose Social determinants of health (SDoH) include socioeconomic and environmental factors that influence individual differences in health status and outcomes. Youth with attention-deficit/hyperactivity disorder (ADHD) have a higher likelihood of concussion than those without ADHD. Some SDoH, such as low socioeconomic status and poor parental mental health, are associated with ADHD. We investigated the associations between SDoH and lifetime history of parent-reported concussion among children and adolescents with ADHD in the United States. Method Participants were parents/caregivers of 5382 children and adolescents (ages 5–17) with parent-reported ADHD from the National Survey of Children’s Health conducted in 2022. Demographic variables analyzed included sex, age group, race, and ethnicity. SDoH variables analyzed included primary language spoken at home, parental level of education, low income, difficulty meeting basic needs, food insufficiency, needed healthcare not received, current health insurance, parental mental health, and sports participation. A multivariate logistic regression examined the combined association of SDoH variables and demographic variables with lifetime concussion history. Results Significant independent predictors (p < 0.05) of higher lifetime history of concussion included older age (Odds Ratio [OR] = 2.32), participation in sports (OR = 1.60), needing healthcare not received (OR = 1.78), and worse parental mental health (OR = 1.48). Significant independent predictors (p < 0.05) of lower lifetime concussion history were not speaking English as the primary language at home (OR = 0.33) and identifying as Black (OR = 0.52). Conclusions Several SDoH were associated with a higher lifetime concussion history, while others were associated with a lower lifetime concussion history among youth with ADHD.