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Teens from poor areas four times more likely to suffer untreated concussion

Otago rugby player Adam Knight is stretchered off after suffering concussion in a 2016 match.

Concussed rugby players from poor schools are four times as likely to go untreated as those from schools in rich areas, new figures reveal.

Experts say the statistics are a major concern, as putting concussed kids back on the field risks lasting damage, and putting them back in the classroom sets them up to fail.

An ACC/Sport New Zealand presentation estimated 1 in 2.6 rugby concussions went untreated in the poorest, decile one and two schools, compared with 1 in 11 concussions in the richest, decile 10 schools.

Only one in four secondary school sports concussions are due to rugby. Titahi Bay teen Zion Trigger Faitele switched to athletics, after suffering concussion playing basketball in November 2016.

The presentation also identified a public relations risk, should media find out about the inequalities.

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Overall injury rates were also higher in the poorest schools, at 32 per cent, compared with the average rate of 25 per cent.

While rugby has by far the most concussions of any individual sport, it makes up only one in four secondary school, sport-related concussions, the presentation noted.

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ACC head of injury prevention Emma Powell said the numbers - crunched by analysts Dot Loves Data - were preliminary, but not surprising.

Globally, injury rates were higher in poorer areas, because of barriers such as access to healthcare and lack of education.

Children's Commissioner Andrew Becroft, a former Youth Court judge, said undiagnosed concussions were a significant concern as untreated symptoms such as severe headaches, loss of concentration and memory loss could derail a teen's life. An English study found two-thirds of young people in custody had suffered a traumatic brain injury.

"I think it is one of the hidden and significantly under-identified and under-diagnosed issues in New Zealand."

Becroft said it was just one of many areas in which poorer children came off worse, but he urged parents to seek treatment and not just dismiss it as a head knock.

Concussion researcher, and Hutt Hospital emergency department nurse, Dr Doug King, also said unmanaged concussions in young people were a "major concern".

"If the kid goes back into school and starts failing, and then they become deviant because they can't cope, you're starting them on a downward spiral. You're setting them up to fail."

All Blacks vice captain Ben Smith leaves Eden Park for a concussion test during the test match against the British and Irish Lions.

King recently had a "really sick" schoolboy in ED, after he'd suffered five head knocks in three weeks, having switched between rugby and rugby league. The mandatory stand-down for young players is supposed to be 23 days for rugby and 28 days for rugby league.

Recently-retired Christchurch school rugby referee John McCormack said better follow-up was needed. While referees reported concussions to the rugby union in Wellington, the same 13- or 14-year-old sometimes turned up again the following week, under a different referee.

While the new concussion blue card was a good addition to Mitre 10 Cup matches, it was young kids who really needed looking after, McCormack said.

"It should not start at the top, it should start at the bottom."

However, NZ Rugby medical director Dr Ian Murphy said it was the responsibility of coaches and team management to ensure concussed players did not return early.

Socio-economic factors were known to be the biggest barrier to accessing medical care, but that was not unique to rugby, Murphy said. The organisation was piloting baseline testing, including in low decile schools, which would help concussion diagnosis.

Rob Sturch - principal of decile two and strong rugby school Hastings Boys' High - was confident concussion was being reported and treated at his school.

Coaches were vigilant, including standing down 1st XV star halfback Folau Fakatava for the 2016 national secondary schools final, because he suffered a head-knock in the semifinal, Sturch said.

The school also had an on-site doctor, so poverty was no barrier to a medical check-up.

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