Time out: The spike in youth concussion diagnoses is a sign of progress

Standout quarterback Casey Cochran began playing football at age 7, eventually achieving his dream of playing college ball at the University of Connecticut.  But during his second year of play—a career of gridiron greatness seemingly stretching out before him—he abruptly quit the game.

The reason? He suffered his thirteenth concussion.

“It was a tough decision,” he said on ESPN’s Outside the Lines.  “I want to be healthy, not just at 20 years, but 40 years and 60 years from now.”

As part of its coverage of concussions in sports, ESPN cited a  Blue Cross Blue Shield, The Health of America Report, which details a recent spike in the number of concussion diagnoses, particularly among youth. Expansive media coverage of football-related concussions and state legislation aimed at preventing participants in youth sports from “shaking off” signs of head injuries have increased public awareness of the seriousness of concussions – and changed attitudes. 

For medical professionals, the heightened concern is welcome.

Overall, Americans 18 years and younger may suffer more than a million concussions annually, according to estimates published this year in the Journal of Pediatrics. These traumatic brain injuries cause a variety of short and long-term ailments including headaches, trouble concentrating and problems with memory, judgment, balance and coordination. Among youth, academic difficulties such as trouble understanding lessons also can result, according to a study by the American Academy of Pediatrics.

Yet for decades, concussions were shrugged off as a normal part of sports and recreation. That seems no longer to be the case.

Concussion diagnoses among teenagers have skyrocketed more than 70 percent over a six-year period, the Blue Cross Blue Shield Association study shows. Diagnoses among adults also rose significantly over the past six years.

The report, “The Steep Rise in Concussion Diagnoses in the U.S.,” is a comprehensive study of medical claims for 936,630 diagnosed concussions suffered by Blue Cross and Blue Shield (BCBS) commercially-insured members from 2010 through 2015.

It finds that:

• Concussion diagnoses spiked 71 percent for patients ages 10 through 19 during the six-year study period. Concussion diagnoses for adults ages 20 through 64 increased 26 percent.
• Fall is the peak concussion season for patients ages 10 through 19 with the most dramatic increases seen among males. Concussion diagnoses for young males in fall are nearly double that of young females.
• Though diagnoses among females have climbed, young males are still being diagnosed with 49 percent more concussions than young females.

“The study shows that there is more awareness about the seriousness of concussions and that younger individuals are receiving more care for these injuries than in the past,” said Dr. Trent Haywood, senior vice president and chief medical officer for BCBSA.

Media attention, efforts by youth sports leagues and the response by public officials are all factors.

In May 2009, the state of Washington approved the Zackery Lystedt Law, after a young football player who was disabled after he sustained a concussion and prematurely returned to a game. The law requires medical clearance of youth athletes suspected of sustaining a concussion before sending them back in the game, practice or training. Within five years of the law’s passage, all 50 states and the District of Columbia adopted many of its core principals.

These laws are effectively ending the old-school approach to dealing with athletic head injuries. Just ask Hobart, Indiana’s Josh Huddlestun, a 26-year-old who grew up playing organized football.

"About 15 years ago, when I played Pop Warner football, I got my first concussion," he told the Chicago Tribune. "I believe I had concussions during my high school football days, but a lot of times it was, 'Oh, you just got your bell rung.' Concussions happen more frequently than people think."

To see the report and others in the Blue Cross Blue Shield, The Health of America Report series, click here.