New Effort Begins to Prevent, Intervene on Concussions

A former surgeon general and a former soccer player are teaming up to do something about reducing head injuries to young athletes.

“We need to change the culture of sports in which the banging of heads is too often celebrated,” the former surgeon general, David Satcher, M.D., Ph.D., and the former soccer player, psychiatrist Eliot Sorel, M.D., told attendees at a meeting in Washington announcing the Protecting Athletes and Sports Safety (PASS) Initiative in November 2013.

The two seek to engage a broad constituency of health leaders, scientists, coaches, trainers, educators, parents, religious groups, and the media in “a sustained national conversation” about concussions.

“We want to raise public awareness on youth-sports safety, increase research, and promote early primary prevention and intervention,” said Sorel, a professor of global health at George Washington University School of Public Health.

The effects of concussions in young people ripple out beyond sports. At the November meeting, two students spoke of the difficulties they had in getting back onto the playing field, but also in getting back into the classroom and taking exams, because the concussions affected their ability to concentrate and think clearly.

Recent events have sparked the need for action. The National Football League recently settled a lawsuit for $765 million, compensating 4,000 former players affected by repeated hits to the head while playing. Mild traumatic brain injuries sustained by U.S. troops in Iraq and Afghanistan have stimulated calls for more research and better treatment.

Then, in October 2013, an Institute of Medicine (IOM) report noted that confusion and controversy still persist about concussions, compounded by a dearth of useful knowledge on the subject.

The IOM “did a great job of identifying the research needs,” said Satcher, director of the Satcher Health Leadership Institute and a professor of medicine at Morehouse School of Medicine.

“We’d like to see the Centers for Disease Control and Prevention collect accurate data on the dimensions of the problem and how it’s distributed in our society,” he said in an interview with Psychiatric News.

“We also need the National Institutes of Health to sponsor clinical studies on the diagnosis and treatment of concussion and how the problem evolves over time,” he said. “We already know it varies by gender—women and girls are more vulnerable—but how do the effects of concussion vary by race, ethnicity, and other factors? And we must learn more about the pathology of concussion, the value of protective equipment, and any predispositions for dementia following concussion.”

Sorel has already tracked head injuries among high school athletes in Fairfax County, Va. He would like to expand that effort to include Washington, D.C., and surrounding counties in Maryland and Virginia. That in turn might serve as a pilot for a national registry.

“The field is so underdeveloped that we cannot now assess risk based on severity,” he said. “We have to develop a severity index as a guide to early identification, prevention, and intervention.”

And research must be coupled with an education campaign aimed at everyone connected with youth sports. “We cannot wait until we have definitive information,” said Sorel. ■