School and community socioeconomic status and access to athletic trainer services in Wisconsin secondary schools.
Post E, Winterstein AP, Hetzel SJ, Lutes B, and McGuine TA. J Athl Training. 2018. [Epub Ahead of Print].
Take Home Message: High schools in Wisconsin with higher median household incomes and lower rates of students receiving free or reduced lunch have more access to certified athletic trainers.
Access to the services of a certified athletic trainer (AT) is valuable for optimizing care of injuries sustained during sport. While many schools have access to an AT, it is unclear which factors may influence the level of coverage (e.g., full time vs part-time AT). Therefore, Post and colleagues completed a cross-sectional survey study to determine if access to AT services differed based on the socio-economic characteristics of secondary schools. Researchers emailed questionnaires to all athletic directors and certified ATs for each of the 492 secondary schools in Wisconsin. The questionnaire assessed school and AT employment information. The socioeconomic status was determined by the percentage of students with free or reduced lunch and the median household income of the county. Both data were acquired from the Wisconsin Department of Public Instruction. Overall, officials from 402 schools completed the survey. Of the respondents, almost all schools (95%) reported some level of access to an AT. Two out of 3 schools reported that an AT was present at athletic events from 3:00 pm to 6:00 pm on an average of 5 school days per week. Schools without an AT had more students with free or reduced-cost lunch (60% vs 41%) and were in communities with lower median household incomes ($~44,300 vs $~52,600). Schools with a lower socioeconomic status were more likely to have less AT access per week (hours/week) and more athletes per AT hour.
Overall, the authors report results that are interesting, if not troubling, about the role socioeconomic status may play on access to ATs in secondary schools. Schools with lower socioeconomic status had less access to an AT than more affluent schools. This data, while unsurprising, suggests that schools which have fewer resources have less access to an AT. This is most likely an issue of limited resources being strategically deployed. This is troublesome because of the lack of an AT deprives students of a key resource that could help ensure detection of injuries, delivery of proper care, and reduced healthcare costs. Based on this evidence, we all need to become advocates for new models that offer a high level of AT access for all students, regardless of socioeconomic status.
Questions for Discussion: As clinicians, how does SEC impact your current position? How have you successfully advocated for an increase in resources which could then result in more ATC access?
Written by: Kyle Harris
Reviewed by: Jeffrey Driban