Relationship Between Athletic Trainer Access, Socioeconomic Status, and Race and Ethnicity in United States Secondary Schools.

Context: Authors of extensive research have exposed health care disparities regarding socioeconomic status (SES) and race and ethnicity demographics. Previous researchers have shown significant differences in access to athletic training services (athletic trainer [AT] access) in the secondary school setting based on SES, but with limited samples.

Objective: To investigate differences in AT access based on race and ethnicity and SES on a national scale.

Design: Cross-sectional study.

Setting: Database study using secondary analysis. Data were collected from the National Center for Education Statistics, Athletic Training Location and Services database, and US Census Bureau.

Patients or other participants: A total of 10 983 public schools.

Main outcome measure(s): Descriptive data were summarized by measures of central tendency. A 1-way analysis of variance determined differences between school characteristics (median household income, percentage of students eligible for free and reduced lunch, percentage of White students, and percentage of non-White students) based on AT access: full-time (FT-AT), part-time (PT-AT), and no AT (no-AT). A Bonferroni pairwise comparison was used for variables with significant main effects.

Results: Across all schools included in the study, 43.8% had no-AT (n = 4812), 23.5% had PT-AT access (n = 2581), and 32.7% had FT-AT access (n = 3590). Significant effects were found between AT access and median household income (P < .001), the percentage of students eligible for free and reduced lunch (P < .001), the percentage of White students (P < .001), and the percentage of non-White students (P < .001). Schools with FT-AT access had a higher SES than PT-AT and no-AT schools. Significant differences existed between AT access groups and the race and ethnicity of schools. Schools with FT-AT access had a significantly lower percentage of non-White students (31.3%) than schools with no-AT (46.0%; P < .001). No significant differences between FT-AT and PT-AT access based on race and ethnicity demographics presented (P ≥ .13).

Conclusions: Schools with higher SES had greater AT access, whereas schools with a higher percentage of non-White students were more likely to have no AT access, demonstrating the disparities in health care extends to athletic health care as well. To increase AT access, future initiatives should address the inequities where larger minority populations and counties of lower SES exist.