School and community socioeconomic status and access to athletic trainer services in Wisconsin secondary schools

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Journal of Athletic Training


Context: Secondary schools have made significant progress in providing athletic trainer (AT) coverage to their student-athletes, but the levels of access at schools with ATs may vary widely. Socioeconomic disparities in medical coverage and access have been noted in other health care fields, but such disparities in the level of access to AT services have not been thoroughly examined. Objective: To determine if (1) access to AT services or (2) the level of access (AT hours per week and athletes per AT hour) differed based on the socioeconomic characteristics of secondary schools. Design: Cross-sectional study. Setting: Mailed and e-mailed surveys. Patients or Other Participants: High school athletic directors and ATs from 402 Wisconsin high schools. Main Outcome Measure(s): Respondents provided information as to whether their school used the services of an AT and the number of hours per week that their school had an AT on-site. The number of athletes per AT hour was calculated by dividing the total number of athletes at the school by the number of hours of AT coverage per week. The socioeconomic status of each school was determined using the percentage of students with free or reduced-cost lunch and the county median household income (MHI). Results: Schools without an AT on-site were in lower MHI counties (P, .001) and had more students eligible for a free or reduced-cost lunch (P, .001). Lower levels of AT access (fewer hours of AT access per week and more athletes per AT hour) were observed at schools in the lowest third of the county MHI and with the highest third of students eligible for a free or reduced-cost lunch (P, .001). Conclusions: Socioeconomic disparities were present in access to AT services. New models are needed to focus on providing a high level of AT access for all student-athletes, regardless of socioeconomic status.

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