This week, our lead article, Concussion symptoms mistaken for alcoholism: United pilot files lawsuit after being wrongly terminated, is in the Culture category.

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In this newsletter: Opportunities, Sports, Women’s Health, & Culture

Writers: Sam Chen, John Rosseel, & Sofia Lozano

Editors: Conor Gormally & Malayka Gormally

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Opportunities

Watch the January - May 2025 webinars produced by the Canadian Concussion Centre; we highly recommend them. New webinars will be available starting this fall. Watch past webinars here.

Wednesday, August 27, 3 pm EDT: A live webinar for healthcare providers, Empowering Patients and Families Through Brain Injury Education, presented by Monique R. Pappadis, MEd, PhD, FACRM, and Wendy Waldman, BSW, CBIST; hosted by the Brain Injury Association of America. Dr. Pappadis has been an Expert Guest Speaker for our Concussion Education & Advocacy Internship Program, and we highly recommend her presentation. “In this webinar, healthcare providers will learn how to better support brain injury survivors and their families by using compassionate, trauma-informed approaches that recognize how educational needs change.” Register in advance (registration is $50 and gives ACBIS continuing education units).

Sports

Racial bias may affect concussion care, risk, for Black athletes

When a sports-related concussion (SRC) occurs, Black athletes may be at higher risk of receiving delayed or inadequate concussion care due to systemic barriers and racial bias, according to a study led by Sydney Wing, PhD, published in The Journal of Athletic Training. The study authors also discuss structural and cultural factors that may make Black athletes more likely to sustain concussions. The researchers conducted a qualitative analysis of 29 articles examining racial differences for Black athletes with SRC to explore the cause behind concussion disparities. They found two primary patterns: (1) biased, unconscious beliefs that Black athletes are “uniquely invincible to injury and pain” and (2) inequitable access to concussion education and medical resources, such as athletic trainers, that can impact risk level, diagnosis, recovery, and outcomes. To illustrate how these factors and patterns are built and interact, the authors adapted an Ecological Systems Theory (EST) framework. This model shows how concussion care is shaped by interconnected social layers, ranging from broad historical forces to individual experiences. These five layers include:

Chronosystem — the legacy of historical dehumanization of Black pain,

Macrosystem — cultural beliefs that define Black athletes as naturally tougher or more resilient,

Exosystem — institutional and socioeconomic barriers such as unequal access to athletic trainers and concussion education,

Mesosystem — how different living communities, like schools, sports organizations, and healthcare settings, interact to influence care,

Microsystem — individual experiences, including interpersonal interactions with families, friends, coaches, or clinicians.

The EST model helps visualize how these layers interact to reinforce bias in concussion diagnosis and care. For example, Black athletes have historically been portrayed as physically more resilient, stemming from a legacy of slavery and dehumanization justified by racial pseudoscience. This history still lives on as harmful assumptions that downplay Black athletes’ pain and injury severity, and these beliefs not only affect how coaches and clinicians respond to injury but also influence athletes themselves. The authors state that the internalization of these damaging biases “is at the crux of continued outcomes for Black individuals in sports,” affecting Black athletes’ ability to perceive or desire to report injuries and pain.

The authors found that exposure to resources and access to care were key factors in outcome disparities. In particular, athletic trainers’ presence not only improves reporting but also knowledge, as athletes are constantly observing injury protocols for others. While better-resourced collegiate or professional Black athletes may have better access to care, they still face systemic barriers during recovery, demonstrating how bias exists at every level––from individual interactions to institutional structures.

Dr. Wing et al. emphasize that recognizing these biases and their impact on providing equitable healthcare is important not only to these athletes but also to all marginalized groups. Understanding how historical and social forces influence healthcare delivery can help providers and communities work together to dismantle harmful stereotypes and improve care for all athletes. This study highlights the necessity of targeted education for coaches, clinicians, and sports organizations, alongside policy changes to reduce structural inequities. By confronting the systemic roots of these disparities, there is potential to create a more equitable and supportive environment for managing sports-related concussions.

Women’s Health

Intimate partner violence leads to higher risk of traumatic brain injury and adverse mental health impacts later in life

A study from Natalie D. Jenkins et al. found that women who experience intimate partner violence with physical abuse (IPV-PA) are exposed to more traumatic brain injuries (TBIs) and have a higher rate of “adverse mental health outcomes…decades after the abuse” compared with women who do not have IPV-PA in their past. The report, published by the British Medical Journal of Mental Health, examined 632 mid-life women (ages 40-59) without a diagnosis of neurodegenerative disease, 90 of whom experienced IPV-PA after the age of sixteen. The participants were selected from the PREVENT Dementia cohort study, which observed brain health in midlife across a variety of backgrounds, including individuals experiencing IPV. All participants were given a questionnaire that asked about past brain injuries, and they were evaluated by a physician for current and past mental health disorders. On average, their abuse ended 27 years before these women participated in the study, yet they had an elevated incidence of mental health disorders compared to the control group. This group of women with a history of IPV-PA not only had an increased incidence of TBI, but they also had a higher likelihood of developing depression, anxiety, sleep disorders, and PTSD compared to the controls. Professor Willie Stewart, who led the study, argued, “Given its prevalence, these findings highlight domestic violence as a public health issue with potential for long-lasting impacts on brain health.”

All participants took the Brain Injury Screening Questionnaire (BISQ) to evaluate their past history of brain injury. Each participant was interviewed by a study physician to determine if they presented symptoms of depression, anxiety, sleep disorders, psychotic disorders, mood disorders, and PTSD. They were also asked if they had a previous diagnosis for any of these. The participants were also given the Lifestressor Checklist Revised (LCR), which evaluated their past experiences with only physical IPV abuse, since the PREVENT study did not screen for sexual abuse. Furthermore, individuals who experienced IPV-PA before the age of sixteen were excluded from the study.

Since this study used data from the PREVENT Dementia cohort study, which primarily observed the brain health of people aged 40-59 years old, it did not focus specifically on IPV. The authors argue that this may have impacted data collection. For example, they found limitations in the LCR as participants may have included non-partner violence in their answers and overestimated the duration of IVP-PA. Jenkins et al. argue these findings necessitate further research into the brain health of people who have experienced IPV.

Culture

Concussion symptoms mistaken for alcoholism: United pilot files lawsuit after being wrongly terminated

Michael Tallon served as Senior Pilot for United Airlines for over 30 years before being terminated after concussion symptoms were mischaracterized as alcoholism. An article in Aviation A2Z by Kevin Derby writes in detail about Michael Tallon's story, leading with the fact that the pilot has filed a federal lawsuit for his wrongful termination. An article from Travel and Tour World explains that in June of 2023, Captain Michael Tallon sustained a concussion after tripping and landing on his head on a cobblestone street during a layover in the Azores. He developed “classic” concussion symptoms, including confusion, slurred speech, and cognitive delays. Instead of receiving medical treatment for his concussion, United Airlines pushed Tallan into the Human Intervention Motivation Study (HIMS), which is a substance abuse recovery program commonly used in the aviation industry. The managers of United Airlines questioned his sobriety based on a single detail: Tallon admitted he enjoyed one drink with dinner. This single admission led his union representative to push "him to admit to alcoholism." With his job on the line if he didn't comply, Tallon was forced to enroll in an inpatient rehabilitation center in Connecticut, where he endured rigorous assessments and counseling for weeks. Multiple health professionals in the facility came to the same conclusion that Tallon did not meet the criteria for any substance abuse disorder, and he was discharged without a diagnosis. After his discharge, United Airlines insisted on additional neuropsychological testing and psychological treatment for "denial." Tallon's primary care physician, outpatient therapist, Alcoholics Anonymous sponsor, an aftercare counselor, and eventually a psychologist engaged by the airline all confirmed the finding: Michael Tallon did not have alcohol use disorder. With the airline still insisting on further testing, Tallon refused, as there was no legitimate diagnosis. In February 2025, United Airlines terminated Michael Tallon.

The Travel and Tour World article states that Tallon's firing "ignited alarm throughout the travel industry." It brought up broader concerns about the airline industry's handling of pilot medical evaluations, specifically when mental health and substance abuse protocols intersect with unrelated medical conditions. His termination indicated that a slip, a fall, or certain symptoms could lead to forced treatment and career termination. This could lead to pilots avoiding reporting injuries or illnesses, jeopardizing aviation safety. This clash also disturbs the trust between pilots and unions tasked with protecting careers. Despite Michael Tallon's 30 years of experience and high-paying salary, he was not protected.

Tallon's fight for protection is not over. His federal lawsuit seeks compensation for wrongful termination, emotional distress, and potential loss of future earnings. This is because the initial response from the airline ignored obvious concussion symptoms and instead focused on speculative alcohol misuse. His complaint points out that the airline avoided millions in long-term disability payments as his termination was categorized under non-compliance with HIMS rather than medical discharge related to his concussion. His attorney, Mike Lueder, emphasized the psychological toll of forcing someone without addiction into intensive substance abuse recovery. Tallon's lawsuit has sparked debate throughout the pilot and aviation industry as pilots wonder if the same thing may happen to them. His case may catalyze a reassessment of how airlines balance safety and employee rights as health concerns arise. As the Tallon and the case move forward, he addresses, "I didn't want to sue anyone. I just wanted to fly. But I had to stand up for myself."

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