Native Hawaiian/Pacific Islander (NH/PI) communities have a large percentage of their youth who participate in contact sports. A Samoan male is 56 times more likely to play in the NFL than an American non-Samoan, therefore, the risk of head trauma is higher in this demographic compared to their non-NH/PI peers, yet there are no neurosurgeons in the U.S. affiliated Pacific Islands. The lack of resources in many NH/PI communities often times places the heavy burden of triaging and caring for these patients on the shoulders of primary care providers and general internists. It is then, imperative to bring awareness to this issue, as well as to seek to optimize surveillance and treatment of head injuries in athletes. 

Research indicates that head injuries in sports are often underreported or dismissed in these communities due to a lack of awareness and testing. A better understanding of what a concussion is, what its symptoms are (both to the physical eye and through sideline concussion testing (SCT)), as well as the need for clear return to play (RTP) guidelines will help this public health issue move toward ideal practice, where second-hit syndrome and long-term effects on the developing adolescent brain can be prevented.