Disparities in sports medicine health care
December 11, 2017 6 Comments
Most days of the week I see my pediatric sports medicine patients in two very different clinics: one is within the inner city of Columbus, Ohio itself; and one is in the foothills of Appalachia, a region described in the recent bestseller, Hillbilly Elegy. Among the patients I frequently see, I have many who could be described as urban poor (the former location), and many as rural poor (the latter).
In my care of these patients, I frequently see them (and their families) struggle with several barriers to excellent care — these range from financial issues, to issues of transportation and distance traveled, to issues of understanding related to educational levels, to a relative lack of resources at their home schools or clubs (e.g. no certified athletic trainers). I feel at a great loss, at times, in trying to help them achieve the same results I would want for any of my patients.
I read with great interest then, in the November 2017 CJSM, a newly published, original research study: Disparities in Athletic Training Staffing in Secondary School Sport: Implications for Concussion Identification. I found it so impactful, that I wanted to talk with the author — and so I tracked down Emily Kroshus ScD, MPH for this episode of the CJSM podcast.
Dr. Kroshus is a Research Assistant Professor of Pediatrics at the University of Washington, who is developing a body of academic work that focuses on “….identifying social and contextual determinants of help seeking behaviors, with an overarching interest in addressing disparities related to gender, race, sexual orientation, and socioeconomic status.”(1)
I hope you are as interested in this sort of research as much as I am. So take a listen to the podcast on iTunes or go to the CJSM website for the podcast (look for the radio button) and the study itself.
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(1) Dr. Kroshus’ biography can be found at the University of Washington faculty page: https://depts.washington.edu/uwgenped/directory/emilykroshus
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Clinical Journal of Sport Medicine Blog 
The conversation in pediatric sports injuries is almost always focused on high school sports, especially when discussing ATs. What about our youth, kids 5 – 14? As Doug Casa of KSI has said, “”Nearly all of the causes of death in sport are influenced by the care [provided] in the first five to seven minutes.” Our youth (ages 5 – 14) organizations rarely, if ever, have sideline medical personnel, proper coach training, an emergency action plan, a documentation system, a communication system, and a tracking / oversight system. We place parents and coaches, who are woefully under educated and under prepared, in the unenviable position of being forced to make a decision with serious consequences.
Robert Huggins, also of KSI, was kind enough to say, “I believe that it is crucial that we continue to develop programs, web-based applications, and platforms that strive to improve health and safety and mitigate risk at all levels of sport. One such platform that provides an easy to implement sports safety system for documentation, communication, education, and oversight is TeamSafe™ and there are many levels of sport that may benefit greatly from its use. Many of our athletes, especially our youngest of athletes at the youth sport level are unable to advocate for themselves, therefore we need to continue to advocate for them.”
Agreed. I think the focus on HS stems from the fact that there is data to be recorded. The phenomenon of having ATCs present lends itself to their performing as reporters (e.g. Dawn Comstock’s RIO database) and, hence, to published research — youth sports, the age range you describe, is I agree a ‘dark’ area of sports medicine research.
You bring up interesting points — if you ever wanted to write a blog post about that subject…..let us know.
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Thanks so much for that! We appreciate the recognition.
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