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Racial and ethnic disparities in pediatric traumatic brain injury: a narrative review of incidence, care, and outcomes
Abstract   Peer reviewed

Racial and ethnic disparities in pediatric traumatic brain injury: a narrative review of incidence, care, and outcomes

R Ammar and R Raghupathi
The American journal of the medical sciences, v 371, pp S345-S346
Feb 2026
DOI: https://doi.org/10.1016/j.amjms.2025.12.557

Abstract

Pediatric traumatic brain injury (TBI) is a leading cause of morbidity and mortality among children in the United States, with lifelong impacts on cognition, behavior, and quality of life. Despite this, the role of racial and ethnic disparities and inequities in shaping the continuum of pediatric TBI incidence and care is underexamined. A narrative review of peer-reviewed studies published through September 2024 was conducted using PubMed, PsychINFO, and SCOPUS databases. Studies were included if they analyzed racial and/or ethnic disparities in pediatric TBI incidence, diagnosis, treatment, outcomes, or caregiver experiences in the United States. Data was categorized by injury type (accidental TBI, abusive head trauma (AHT), and concussion). Although racial minorities were more likely to be examined for suspected child abuse, there was no clear evidence that these children experienced AHT at higher rates compared to White children. The incidence of accidental head trauma due to falls and motor vehicle accidents was greater in Black, Hispanic, and Native American/Native Alaskan children compared to White children. Black and Hispanic youth were more likely to be underdiagnosed with concussions due to a lack of access to specialized care. Overall, minority children were more likely to experience delayed or nonspecific diagnoses, reduced access to specialty care and rehabilitation, and higher hospital costs compared to White children. This led to increased emotional and financial strain, as well as greater unmet needs, among caregivers of these families. While some recent evidence suggests narrowing disparities in acute care, inequities persist in recovery, functional outcomes, and access to long-term services. Racial and ethnic disparities and inequities significantly shape the diagnosis, care, and outcomes of pediatric TBI patients in the United States. Addressing these inequities requires large, prospective, multicenter studies that incorporate social determinants of health, alongside culturally responsive interventions and policies aimed at improving equity in access to specialty care, rehabilitation, and long-term support. Efforts to reduce these disparities are essential for advancing health equity and ensuring high-quality care for all children affected by TBI.

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