I am pleased to introduce readers to the Journal of Athletic Training’s thematic issues on diversity, equity, inclusion, and access (DEIA) in athletic training. These issues represent a collection of articles that address DEIA matters in the context of patient care provided by athletic trainers and professional concerns facing the athletic training community. The goal of these thematic issues is to highlight contemporary DEIA scholarship in athletic training, including health disparities, social determinants of health, cultural competence, access to health care, and professional development and workplace concerns in athletic training. For the purposes of the thematic issues, DEIA was intentionally defined broadly to comprise matters related to race, ethnicity, gender, gender identity and expression, sexual orientation, socioeconomic status, disability, religion, national origin, and any other marginalized, underrepresented, or underserved communities.
Some may question the need for thematic issues on DEIA or view the topic itself as being inherently polarizing and divisive. To address these concerns, I would like to explain why the Journal of Athletic Training curates thematic issues on focused topics. We do so to highlight areas of contemporary scholarship that can advance athletic training clinical practice and serve as a beacon that the Journal of Athletic Training is a viable outlet for scholarship related to these topics. The past several years have seen a proliferation of DEIA scholarship in athletic training. These thematic issues represent a compendium of such research and signal that the Journal of Athletic Training welcomes future submissions of DEIA scholarship. I acknowledge that DEIA concepts are viewed by some as being polarizing or divisive; however, I contend that if we did not address DEIA in the flagship journal of the National Athletic Trainers’ Association, we would be intentionally ignoring major topics pertinent to patient-centered care and the advancement of the athletic training profession. The journal’s readership is best served if we intentionally address DEIA content in our pages and promote professional discourse on these topics.
Others will contend that a thematic issue on DEIA in athletic training is long overdue, and I do not disagree with them. The idea of a DEIA thematic issue was first proposed to me by Alejandra Merriman, DAT, ATC, in October 2020, when she posted on Twitter that the Journal of Athletic Training should develop a special issue about “social determinants of health and cultural competence.” After seeing this suggestion, I initiated a conversation with Dr Merriman about this idea. Although I agreed that DEIA concerns were critically important to athletic trainers and the patients we treat, at that time, I did not sense that there was an adequate volume of DEIA–related scholarship to fill a thematic issue. In the ensuing years, the proliferation of DEIA-related scholarship in athletic training has reached the point that these 2 thematic issues are now possible. I sincerely thank Dr Merriman for the impetus to develop them.
The catalyst for the increase in DEIA scholarship can be traced to the national reckoning with the murder of George Floyd in May 2020 and National Athletic Trainers’ Association’s prioritization of DEIA initiatives in recent years (see the Lopez and Bates editorial in this issue for details on these initiatives). However, the DEIA scholarship in athletic training originated several decades ago. In 2000, Journal of Athletic Training Editor-in-Chief David Perrin, PhD, ATC, authored an editorial in which he stated, “our record on diversity with regard to race and ethnicity is abysmal” and challenged all athletic trainers to “not just tolerate but celebrate the diversity that currently exists in our profession and commit ourselves to beginning a dialogue and develop a plan to increase diversity among our students and colleagues.”1 In the ensuing decades, groundbreaking scholarship has been published addressing topics such as cultural competence, social determinants of health, racial disparities in Board of Certification examination performance, the relationship of socioeconomic status with access to athletic training services in secondary schools, and the low prevalence of racial and ethnic minority athletic trainers in collegiate athletics.2–11 Please note that this list is not meant to include all prior DEIA–related scholarship in athletic training. Any omissions were not intentional. Such work has laid the foundation for much of the content in these special issues.
The Journal of Athletic Training has also made mistakes related to DEIA within our pages. In 2023, we published an article about common dermatologic conditions in athletes.12 We received rightful criticism that none of the 11 images in that article were of Black, Indigenous, or people of color. This omission of images of Black, Indigenous, or people of color should have been corrected during the review and editorial process; however, this serious omission was neither noticed nor acted upon. As Editor-in-Chief, I took full responsibility for this error and pledged that we would do better in the future. I highlight this episode to not only show my personal commitment to DEIA but also serve as an example that we all have implicit biases and have most likely made errors such as this in our daily professional lives. Speaking out when inappropriate acts of commission or omission are witnessed is necessary for all of us to do better when it comes to matters of DEIA. The current thematic issues focusing on DEIA do not atone for the Journal of Athletic Training’s past mistakes, yet I hope they demonstrate our commitment to advancing the clinical care provided by athletic trainers and the athletic training profession as a whole.
In these thematic issues, readers will find a series of editorials and commentaries regarding the current landscape of DEIA in athletic training, current clinical concepts articles on health literacy and community outreach to underserved populations, and original research and review articles that address access to athletic training and other health care services, social determinants of health, clinical management of concussion, mental health, nutrition, injury prevention, transgender and gender-diverse patients, and professional concerns facing athletic trainers from historically underrepresented populations as well as attitudes about appearance-based professionalism.
It is my hope that the contents of these thematic issues serve as a contemporary resource for athletic trainers and other sports medicine clinicians, as an impetus to increase dialogue and spur actions that advance DEIA initiatives in athletic training and sports medicine, and as a springboard for more scholarship in this critically important topical area. Thank you to the authors for sharing their DEIA scholarship and to you, the readers, for engaging with this content.