The Association Between the Social Vulnerability Index and Access to California High School Athletic Trainers.

Abstract

Context: Social determinants of health are known to affect overall access to youth sports; however, it is not fully understood how multiple social determinants of health may affect access to school-based athletic training services.

Objective: To determine the relationship between Social Vulnerability Index (SVI) scores on access to high school-based athletic trainers (ATs) in California.

Design: Retrospective, cross-sectional study.

Setting: Online survey.

Patients or other participants: California Interscholastic Federation (CIF) high school respondents of the 2022-2023 Participation Census.

Main outcome measure(s): Association between SVI scores and access to school-based AT services. In this study, we used data from CIF high school respondents of the 2022-2023 Participation Census. School addresses were used to extract SVI scores from the US Census Bureau. Separate multivariable logistic regressions and generalized linear mixed effects models assessed the relationships between access to school-based athletic training services and SVI scores at the census and county levels.

Results: Of the 1598 respondent schools (65% public, 24% private, and 11% charter), 49% reported having an AT, of which 41% were certified. Adjusted analyses revealed that increased vulnerability in household characteristics was associated with lower odds of access to ATs and certified ATs at both county (odds ratio [OR] = 0.89 [95% confidence interval (CI) = 0.80, 0.99]; P = .04) and census tract levels (OR = 0.93 [95% CI = 0.89, 0.97]; P = .002). Increased vulnerability in socioeconomic status was associated with lower odds of having a certified AT at the census tract level (OR = 0.94 [95% CI = 0.89, 0.98]; P = .006) but not the county level (P = .16).

Conclusions: Increased vulnerability in household characteristics is associated with decreased odds of access to high school-based athletic training services.