Toronto, ON, July 11, 2025 鈥� A new study finds socioeconomic disparities in rates of emergency department (ED) visits for concussion among children and youth.

Researchers from ICES, 91亚色, Toronto Metropolitan University, and the University of Calgary found an increase in ED visits for concussion among all age groups prior to the pandemic, with the biggest increase among older children and teens (ages 10 to 19 years). However, children in the highest socioeconomic status group accounted for significantly more concussion-related ED visits than children in the lowest socioeconomic status group.

鈥淭hese trends are concerning, and flag a potential issue of equity among youth who may not have access to the same protocols and support for concussion care that we see in higher income populations,鈥� says lead author , a professor in the School of Kinesiology and Health Science at 91亚色 and senior adjunct scientist at ICES.聽

The study, published in the , analyzed data for all Ontario ED visits for children and adolescents (ages 0 鈥� 19 years old) with a diagnosis of concussion between 2010 and 2020. Socioeconomic status was assessed using categories of household material deprivation, which includes low income, unemployment, single parent families, parents without a high school diploma, and living in dwellings in need of major repair. The data were analyzed by age and sex.

There was a rise in concussion-related ED visits for all age groups. The 10-14 and 15-19 age groups had the greatest increases, from 350 and 382 per 100,000 in 2010 to 737 and 872 per 100,000 in 2019, respectively.

Further, rates among children with the lowest socioeconomic status rose from 36.7 in 2010 to 43.3 in 2020, compared to 62.6 and 61.8 for children in the highest socioeconomic status group.

While a large proportion of concussions are related to sports, which may be inaccessible to children with lower socioeconomic status, the socioeconomic gradient remained in 2020 when most organized sports were put on hold due to the COVID-19 pandemic. It is unlikely that sport participation is the鈥痮nly reason for the differences and there may be systemic barriers to concussion diagnoses.

The researchers suggest that reasons for lower rates of emergency department use among children and youth from low socioeconomic populations could be children鈥檚 distance to hospitals, lack of information about concussion, and language or cultural barriers.

This is one of the first large, population-based studies to reveal an association between socioeconomic status and emergency department visits for concussion, while also showing changes in concussion visits over time, analyzed by age and sex. One limitation is that concussions may have been underrepresented if children did not seek medical attention for their injury, or if they saw a family doctor or other health care provider instead of visiting the ED. The researchers note that further study is needed to understand the full scope of concussion-related healthcare utilization.

鈥淚t鈥檚 important that policy-makers, school boards, and coaches and teachers are aware of the socioeconomic differences in concussion-related emergency visits, so that they consider equity when creating policies about concussion and when delivering concussion prevention programs,鈥� says senior author Linda Rothman, an associate professor for the School of Occupational and Public Health at Toronto Metropolitan University.聽

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FOR FURTHER INFORMATION PLEASE CONTACT:鈥�&苍产蝉辫;

Emina Gamulin
91亚色 Media Relations and External Communications
egamulin@yorku.ca
437-217-6362听

Misty Pratt
Senior Communications Associate, ICES
Media@ices.on.ca
343-961-6982听听

Michelle LePage
PR and Communications Specialist, Toronto Metropolitan University
michelle.lepage@torontomu.ca 

91亚色 鈥�is a modern, multi-campus, urban university located in Toronto, Ontario. Backed by a diverse group of students, faculty, staff, alumni and partners, we bring a uniquely global perspective to help solve societal challenges, drive positive change, and prepare our students for success. 91亚色鈥檚 fully bilingual Glendon Campus is home to Southern Ontario鈥檚 Centre of Excellence for French Language and Bilingual Postsecondary Education. 91亚色鈥檚 campuses in Costa Rica and India offer students exceptional transnational learning opportunities and innovative programs. Together, we can make things right for our communities, our planet, and our future.鈥��

滨颁贰厂鈥�is an independent, not-for-profit research and analytics institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. ICES leads cutting-edge studies and analyses evaluating healthcare policy, delivery, and population outcomes. Our knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about healthcare delivery and to develop policy. For the latest ICES news, follow us on BlueSky and LinkedIn: @ICESOntario 

Toronto Metropolitan University is a world-class research institution and Canada鈥檚 leader in innovative, career-oriented education. TMU offers more than 60 undergraduate programs, over 65 graduate programs, and 80 continuing education certificate programs. The university boasts ten faculties, including the Lincoln Alexander School of Law and the new TMU School of Medicine, which is launching in September 2025. Established in 1948, TMU is home to nearly 48,000 students, including 2,900 master鈥檚 and PhD students, 4,000 faculty and staff, and over 245,000 alumni worldwide. For more information, visit torontomu.ca. 

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TORONTO, ON, January 15, 2024 鈥� Cycling and pedestrian injuries are severely underrepresented by police data, particularly those not involving a motor vehicle,  believed to be the first of its kind in Canada.

The study, led by 91亚色 and ICES in collaboration with a researcher from Toronto Metropolitan University, analyzed Toronto Police Service (TPS) data and health administrative data from ICES. 

The researchers found more than 30,000 emergency department (ED) visits for all cyclist injuries between 2016 and 2021 from health services data, which includes both injuries sustained from motor vehicle collisions (MVC) and non-MVC. In contrast, TPS data captured 2,362 minor, major and fatal cyclist injuries for all cyclist collisions, representing only eight per cent of ED visits.

Police generally only attend injuries sustained when there is a motor vehicle involved; however, the study found a large proportion of cyclist injuries that don鈥檛 involve a motor vehicle, especially since the pandemic. Of the total hospital admissions for cycling injuries, more than 80 per cent were from non-MVC.

Police data estimates improved when the data was limited to cyclist-MVC and pedestrian injuries. For pedestrians, the police data represented 54 per cent of ED visits and 48 per cent of hospitalizations, and injuries decreased across all data sets since 2020.

"This suggests that using police data alone won鈥檛 provide city planners with an accurate number of cyclists and pedestrians injured on city streets," says lead author , professor in the School of Kinesiology and Health Science at 91亚色 and senior adjunct scientist at ICES. "This emphasizes the need for linked health services data and police data to inform planning for road safety."  

The study authors note that since the police data and health services data were not linked, a detailed analysis and comparison between the data sets was not possible. Future work to link these data would allow for a better understanding of which injuries are being missed by police data, demographics of the individuals, and locations where collisions are occurring.

鈥淭he high rates of serious cycling injuries that don鈥檛 involve motor vehicles may point to changes that are needed in the built environment,鈥� says senior author Linda Rothman, assistant professor for the School of Occupational and Public Health at Toronto Metropolitan University. 鈥淭his could include roadway and cycle track maintenance or necessary upgrades to off-road trails and pathways.鈥�

This study was an Applied Health Research Question (AHRQ) requested by the City of Toronto, and they are using the results to plan road safety changes, including to cycling infrastructure that is not on the roadway. Two other regions in Ontario have recently requested the same data to inform their planning.

The study, 鈥淎 comparison of the number of pedestrian and cyclist injuries captured in police data compared to health service utilization data in Toronto, Canada 2016-2021鈥� was published inInjury Prevention.

Authors: Macpherson AK, Zagorski B, Saskin R, Howard AW, Harris MA, Namin S, Rothman L.

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