Indiana State University, Terre Haute.
J Athl Train. 2024 Apr 1;59(4):381-387. doi: 10.4085/1062-6050-0737.21.
The social determinants of health (SDOH) are circumstances under which individuals are born, work, and live that influence health outcomes. Previous researchers have examined 1 determinant of economic stability and found disparities in socioeconomic status and athletic trainer (AT) availability.
To examine the SDOH characteristics of Indiana secondary schools and AT availability.
Cross-sectional study.
Database secondary analysis.
A total of 426 secondary schools.
MAIN OUTCOME MEASURE(S): All data were collected from publicly available databases. The independent variable was AT availability, and schools were classified as having a full-time AT, a part-time AT only, or no AT. The SDOH variables were gathered for each school (at the school and county levels). Data were summarized using measures of central tendencies, 1-way analysis of variance, and Kruskal-Wallis tests.
School enrollment was larger in schools with greater AT availability (P< .001). The proportion of non-White students was greater in schools with more AT availability (P= .002). Greater AT availability was present in counties with higher graduation rates (P= .03). Post hoc comparisons revealed differences in graduation rates between schools with a part-time AT and those with no AT (P= .04). Schools with less AT availability were located in counties with a slightly higher percentage of the population uninsured (P= .02). Schools with greater AT availability were located in counties with a higher ratio of population to primary care physicians (P= .03). Schools with less AT availability were located in counties with a higher population experiencing severe housing problems (P= .02). No differences were found in AT availability based on the 3 social and community context variables (P> .05).
Differences were noted in AT availability and SDOH characteristics at the secondary school level. We observed less AT availability where high school graduation rates and the population of primary care providers were lower. Strategies should be implemented to improve access to athletic health care in underresourced communities.
健康的社会决定因素（SDOH）是指个人出生、工作和生活的环境，这些环境会影响健康结果。先前的研究人员已经研究了经济稳定的一个决定因素，并发现社会经济地位和运动训练师（AT）的可用性存在差异。
检查印第安纳州中学的 SDOH 特征和 AT 的可用性。
横断面研究。
数据库二次分析。
共有 426 所中学。
所有数据均来自公开可用的数据库。自变量是 AT 的可用性，学校分为全职 AT、兼职 AT 或没有 AT。SDOH 变量是为每所学校（在学校和县城一级）收集的。使用中心趋势、单因素方差分析和克鲁斯卡尔-沃利斯检验对数据进行总结。
AT 可用性较高的学校的入学人数较多（P<.001）。AT 可用性较高的学校中非白人学生的比例较大（P=.002）。毕业率较高的县 AT 可用性较高（P=.03）。事后比较显示，有兼职 AT 的学校和没有 AT 的学校之间的毕业率存在差异（P=.04）。AT 可用性较低的学校所在的县，未参保人口比例略高（P=.02）。AT 可用性较高的学校所在的县，人口与初级保健医生的比例较高（P=.03）。AT 可用性较低的学校所在的县，人口中面临严重住房问题的比例较高（P=.02）。根据 3 个社会和社区背景变量，没有发现 AT 可用性的差异（P>.05）。
在中学层面上，AT 的可用性和 SDOH 特征存在差异。我们发现，在高中毕业率和初级保健提供者人数较低的地方，AT 的可用性较低。应实施策略，以改善资源匮乏社区的运动保健服务。
