Question Period Note: Concussion

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Sports and recreational activities have many social and health benefits and are an important part of the lives of children and youth in Canada. Concussions are more common in some sports and recreational activities than in others. Efforts are underway to prevent, recognize and manage the public health issue of concussions in Canada.

Key Messages
• The government recognizes that too many children and youth experience concussions during sports and recreation activities, sometimes with tragic outcomes.
• Through the Canadian Institutes of Health Research, the government has invested $51 million over the last 5 years in research and initiatives to improve the prevention, diagnosis, and treatment of traumatic brain injuries, including concussions.
• We have strengthened our surveillance of concussions and other traumatic brain injuries by partnering with Statistics Canada on a Rapid Response Survey on Head Injuries/Concussions.
• The Public Health Agency of Canada launched a challenge in the summer of 2022, seeking solutions to prevent severe health outcomes associated with concussions. The Challenge is implemented under the Innovation, Science and Economic Development Innovative Solutions Canada program.
• We continue to work closely with provincial and territorial counterparts on the pan-Canadian concussion strategy and raising awareness for parents, coaches, and athletes on concussion treatment.

The Minister of Health was mandated in 2015 and 2019 to work with the Minister of Canadian Heritage to implement a pan-Canadian concussion strategy and raise awareness for parents, coaches, and athletes on concussion treatment.

Budget 2016 committed $1.4 million to support the development and implementation of a harmonized approach with provinces and territories to concussion prevention, detection, and management in Canada. With PHAC funding, a national injury prevention organization (Parachute) created the Canadian Guideline on Concussion in Sport (2017) to present a harmonized approach to concussion management.

In November 2018, the Public Health Agency Canada (PHAC) provided Parachute with $1.18 million in funding to produce education and awareness resources for parents and school and sport stakeholders to support Canadians in their return to school, sports and daily activities post-concussion, as well as provide resources for medical and allied health professionals. PHAC also funded the SCHOOLFirst project to provide information to Canadian teachers and school boards on best practices for students returning to school after a concussion and the Concussion Ed app to help parents manage their child's concussion.

On May 23, 2019, PHAC released the “Understanding and Awareness of Sport-Related Concussions, With a Focus on Youth” public opinion research. The results suggest that Canadians are becoming better informed about concussions.

In August 2020, PHAC released a comprehensive surveillance report on traumatic brain injuries and concussions in Injury in Review, 2020 edition: Spotlight on Traumatic Brain Injuries Across the Life Course. This report provides national surveillance statistics on head injuries and traumatic brain injuries across the life course, including deaths, hospitalizations, and emergency department visits.

In addition, PHAC partnered with Statistics Canada to develop and implement a rapid response survey on concussions. The survey was completed in winter 2020-21, and survey findings are expected to be reported on in July 2023. This data will provide national estimates from a self-reported survey on the number of people over the age of 12 that experienced a concussion or head injury in 2019.

PHAC will also continue to monitor the effects of COVID-19 on the prevalence and mechanism of concussions and traumatic brain injuries across Canada through available data sources such as emergency department and hospitalization data.

On July 18, 2022, PHAC launched the Concussion Detection Challenge, which is being delivered through the Innovative Solutions Canada program run by Innovation, Science and Economic Development Canada. The Challenge aims to prevent severe health outcomes associated with concussions by encouraging innovators to bring forward solutions that detect concussions using objective clinical indicators. The intent is to generate user-friendly solutions that can be used by health practitioners and allied professionals with little specialized training.

The Concussion Challenge gained the attention of concussion experts across Canada with 33 submitted proposals from July to September 2022. In phase 1, three finalists will receive up to $150,000 each to fully develop their idea. These finalists are expected to be announced in spring 2023. A final winner will be selected in 2023-24 and will receive up to $1 million, for a total of up to $1.15 million for the two phases.

In collaboration with Sport Canada, webpages were created to provide Canadians with the latest concussion information and tools (canada.ca/concussions; canada.ca/commotions-cerebrales).

Canadian Institutes of Health Research (CIHR)
Between 2017-18 and 2021-22, CIHR invested $51 million in research on traumatic brain injuries, including concussions, with $12.1 million invested in 2021-22 alone. This includes a $1.5 million, five-year Network Catalyst Grant to Dr. Keith Yeates at the University of Calgary to establish the Canadian Concussion Network (CCN). This network brings together Canadian concussion researchers, clinicians and stakeholders from multiple fields – including sports, health, education, and industry – to shape best practices and policies in the prevention, diagnosis, treatment, and management of concussions, with a particular focus on youth and sport.

Canadian Heritage
Budget 2019 provided $30 million over 5 years for Sport Canada to ensure a safe and healthy sport system, including funding in the amount of $800,000 annually over five years to National Sport Organizations (NSOs) and targeted Multisport Service Organizations (MSOs). The funding will enable NSOs and MSOs to harmonize their return-to-sport protocols with the latest Canadian Guideline on Concussion in Sport, to work in the areas of awareness, prevention, and surveillance and to ensure better alignment of concussion resources with provincial and territorial sports organizations.

Since April 1, 2021, Sport Canada funding recipients are now required to have a policy on concussion that covers the areas of awareness, prevention, detection, surveillance, and management, which includes a specific Return-to-sport protocol compliant with the latest Canadian Guideline on Concussion in Sport.

Federal/Provincial/Territorial (FPT) Considerations
The Government of Canada works with FPT Ministers responsible for sport, physical activity and recreation (SPAR) on harmonizing approaches for concussion prevention and management in sport. In September 2021, federal, provincial and territorial governments, in collaboration with the sport and health sectors, worked together to launch the first annual concussion awareness week/day. In August 2022, SPAR Ministers agreed to direct officials to continue the harmonized national efforts on concussion awareness, prevention, detection, and management aligned to the priorities agreed to in 2019.

Ontario is the only province that has concussion-specific legislation in force. Rowan’s Law, 2018, requires sports organizations to have concussion protocols in place and proclaims Rowan’s Law Day to be observed annually on the last Wednesday in September. The law also amends the Ontario Education Act to authorize the Minister to establish and require boards to comply with policies and guidelines on student concussions.

Parliamentary Business
During the previous Parliament, the House of Commons Standing Committee on Health (HESA) established a Subcommittee to undertake a study on sport-related concussions. In June 2019, HESA tabled the Subcommittee’s report entitled “Tackling the Problem Head-on: Sports-Related Concussions in Canada”. The Government Response was presented to the House of Commons June 23, 2021 and is publicly available on the Standing Committee on Health’s webpage.

• Concussion is a recognized public health issue, which can result in short and long-term effects on brain health.
• An estimated 46,000 children and youth, aged 5-19 years, were diagnosed with a concussion by hospital emergency departments in 2019-20. During the pandemic in 2020-21, this number reduced significantly, but surveillance from 2021-22 indicates the number is increasing back toward pre-pandemic levels.
• Ice hockey, rugby and ringette are the sports with the highest proportion of traumatic brain injuries, including concussion, ranging from 27% to 44% of injuries in children and youth aged 5-19 years, reported by select hospital emergency departments in 2018-19.