Context: Baseball is a popular sport in the United States, with widespread play among secondary school student-athletes. Baseball-related injuries may vary based on community-level socioeconomic status of schools.

Objective: To describe the injuries sustained by secondary school baseball players from schools categorized by community-level socioeconomic status.

Design: Cross-sectional study design.

Setting: Data (2014/15-2018/19 academic years) were obtained from the National Athletic Treatment, Injury, and Outcomes Network (NATION-SP)

Participants: Secondary school baseball athletes.

Main Outcome Measures: Frequencies and percentages of injuries, injury rates, and competition/practice injury rate ratios (IRR) were reported by the community-level socioeconomic status (ie, affluent, average wealth, disadvantaged) where each school is located.

Results: NATION-SP captured 320 baseball injuries across 140,619 total athlete exposures (AEs), for an overall injury rate of 2.4/1,000 AEs. Of those, 52% occurred among athletes in 24 schools situated in affluent communities, 15.6% occurred in 12 schools from average wealth communities, and 32.5% occurred in 12 schools located in disadvantaged communities. The largest injury rate was schools located in disadvantaged communities (3.3/1000 AE), followed by affluent (2.3/1000 AE) and average wealth (1.4/1000 AE) communities. On average, schools from affluent and disadvantaged communities had higher injury rates during competition than during practice (affluent: IRR=1.5, 95% CI=1.11, 2.05; disadvantaged: IRR=1.6, 95% CI=1.12, 2.41). Frequencies of many injury characteristics were consistent in schools across community-level socioeconomic status with contact, sprain/strain, and non-timeloss ranking highest in terms of injury mechanism, diagnosis, and time loss, respectively. Shoulder/clavicle was most frequent body part injured in schools in average and disadvantaged wealth communities, and ankle was most frequent in schools in affluent communities.

Conclusions: Baseball athletes playing in schools located in disadvantaged wealth communities had the largest overall injury rate, followed by schools in affluent, and average wealth communities. Across most injury characteristics, a consistent trend emerged regardless of community-level disadvantage, with the highest baseball injury rates resulting from contact mechanisms, diagnosed as sprains or strains, and classified as non-time- loss injuries. While many injury patterns are consistent across socioeconomic communities, examining injuries through the lens of community-levels of disadvantage provides insight into subtle differences that could information targeted prevention strategies or resource needs.

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