Traumatic brain injury among hispanic children in the United States: a comprehensive systematic review of the literature.

Pediatric traumatic brain injury (TBI) is a leading cause of morbidity and mortality in the United States. Hispanic children face disproportionate socioeconomic disadvantage, underinsurance, and language barriers, yet disparities in their TBI outcomes remain under-investigated. This systematic review aims to (1) synthesize existing evidence on the epidemiology, mechanisms of injury, and outcomes of TBI among Hispanic children in the United States; (2) evaluate disparities in healthcare access, diagnostic evaluation, and access to rehabilitation services; and (3) identify gaps in the literature to inform culturally responsive prevention and intervention strategies. A systematic search of PubMed, Scopus, Web of Science, Embase, and Google Scholar was conducted in accordance with PRISMA 2020 guidelines. Eligible studies included those reporting primary data on TBI among Hispanic children (< 18 years) in the United States. Data were synthesized qualitatively given heterogeneity in study design, outcome measures, and population characteristics. Fifteen studies met the inclusion criteria and were evaluated using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Hispanic children sustained TBIs at younger ages and were disproportionately affected by severe mechanisms of injury, including falls from buildings, motor vehicle accidents, and violence. Helmet use was markedly lower among Hispanic children compared to their White peers. Across studies, Hispanic children exhibited higher rates of mortality (13.3% vs. 8.9% in White children). The payer-related barriers correlated with reduced access to inpatient rehabilitation and higher unmet post-discharge needs. Longitudinal studies demonstrated persistently poorer functional outcomes for Hispanic children, particularly in Spanish-speaking families, underscoring the amplifying role of language discordance. Hispanic children experience cumulative disparities in TBI that span exposure, acute care, and long-term recovery. These inequities are driven by structural determinants, including socioeconomic disadvantage, underinsurance, and language barriers, which transform an acute injury into a chronic disability. Interventions to mitigate these disparities must include culturally tailored prevention strategies, expansion of telemedicine, and integration of bilingual services. Further research is needed to disaggregate Hispanic subgroups and evaluate targeted interventions to achieve equity in pediatric TBI outcomes.