Social Determinants of Traumatic Brain Injury in the North American Indigenous Population: A Review.

Objective: Given the difficult to navigate literature on social determinants in Indigenous traumatic brain injury (TBI) we wished to identify all available literature on the social determinants of health linked to TBI in the North American Indigenous populations.

Methods: We performed a systematically conducted review. We searched MEDLINE, BIOSIS, EMBASE, Global Health, SCOPUS, and Cochrane Library from inception to January 2016. A two-step review process of the search results was performed, applying defined inclusion/exclusion criteria. The final group of articles had the data extracted and summarized.

Results: Ten manuscripts were identified to discuss some social determinant linked to TBI in the North American Indigenous populations. Two studies were focused on Canadian populations, with the remaining 8 studies focused on populations within the United States. Six social health determinants were identified within the studies, including: Rural location (Physical Environment) in seven studies, Male gender in five studies and Female gender in one study (in the setting of interpersonal violence) (Gender), Substance use in four studies and failure to utilize personal protective equipment in one study (Personal Health Practices and Coping Skills), Interpersonal Violence in one study (Social Environment), availability of rehabilitation services in one study (Health Services), and lack of family and friend presence during meetings with healthcare professionals in one study (Social Support Network).

Conclusions: To date, little literature is available on the social determinants that impact TBI in the North American Indigenous population. Further research is warranted to better determine the incidence and social determinants associated.