Context: Significant health care disparities exist in the United States based on socioeconomic status (SES) but the role SES has on secondary school athletes' access to athletic training services has not been examined on a national scale.

Objective: To identify differences in access to athletic training services in public secondary schools based on school-SES.

Design: Cross-Sectional Study

Setting: Database secondary analysis.

Patients or Other Participants: Data for 3,482 public high schools.

Main Outcome Measures: Data were gathered from the Athletic Training Location and Services (ATLAS) database, United States Census Bureau, and National Center for Education Statistics (NCES). We included schools from 5 states with the highest, middle, and lowest poverty percentages (15 states total) and collected county median household income (MHI), percentage of students eligible for free and reduced lunch, race/ethnicity demographics, and access to athletic training services (full-time AT, part-time AT only, no AT) for each school. Data were summarized in standard deviations, means, medians, interquartile ranges (IQR), frequencies and proportions, one-way ANOVAs, and Kruskal-Wallis tests.

Results: There were significant differences in school-SES between schools with full-time, part-time only, and no athletic training services. Schools with greater access to athletic training services had fewer students eligible for free and reduced lunch (full-time: 41.1%±22.3, part-time only: 45.8%±24.3, no AT: 52.9%±24.9, p<0.001). Similarly, county MHI was higher in schools with increased access to athletic training services (full-time: Median [IQR], $56,026 [$49,085–$64,557], part-time only: Median [IQR], $52,719 [$45,355–$62105], and no AT: Median [IQR], $49,584 [$41,094–$57,688], p<0.001).

Conclusions: SES disparities were present in access to athletic training services in a national sample of public secondary schools. Access to athletic trainers positively influences student-athlete's health care across several measures. Pilot programs or government funds have been used previously to fund athletic training services and should be considered to ensure equitable access regardless of school-SES.

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