Objective To assess the effect of socioeconomic status on concussion recovery. We hypothesized that higher SES will exhibit higher scores and shorter recovery outcomes.

Design Prospective, between-groups cohort design.

Setting Urban and suburban high school athletes (N=596) in Ohio were administered the ImPACT® battery during baseline and post-injury assessments.

Participants Participants were grouped based upon SES (high n=292 and low n=304)

Interventions Participants were tracked throughout the season to determine concussion occurrence (high n=30 and low n=28) and time loss following injury to establish recovery curves.

Outcome Measures ImPACT® composite scores and time loss served as dependent variables. Comparisons between groups were calculated using One-Way ANOVAs (a priori significance < 0.05).

Main Results Statistically significant differences existed between SES groups on composite verbal memory (F_(1,595)=8.28, p=0.006), composite visual memory (F_(1,595)=23.13, p>0.001), and composite visual motor speed (F_(1,595)=25.27, p>0.001). Those athletes in the higher SES group performed better than the low SES group. A statistically significant difference existed for time loss (F_{(1, 57)}=19.36, p>0.001), with athletes in the lower SES group returning to participation before the high SES group.

Conclusions Despite statistically significantly lower composite verbal memory, composite visual memory and composite visual motor speed scores post-injury, the low SES group was able to return to full participation on average 7 days sooner than their high SES counterparts. Future research should examine the mechanism of SES in concussion assessment and develop clinical paradigms and interventions for adolescent athletes in varying socioeconomic populations.