Influence of High School Socioeconomic Status on Athlete Injuries during the COVID-19 Pandemic: An Ecological Study.
Garrett Bullock, Albert Prats-Uribe, Charles Thigpen and 3 others
PMID 36518837WHAT IT FOUND
During the pandemic return to sports, athletes from lower-income high schools had higher injury rates than those from wealthier schools, especially in collision sports.
However, in the pre-pandemic year, higher income was associated with more injuries. The study cannot prove why this changed.
Key findings
01In the 2020-2021 pandemic academic year, lower socioeconomic high schools reported increased injury incidence compared to higher socioeconomic high schools.
02In the 2019-2020 pre-pandemic year, higher median household income was associated with increased injury incidence, but no such association was found in the 2020-2021 year.
03The difference in injury trends between socioeconomic groups was most pronounced in male athletes and those participating in collision sports.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used school district income as a proxy for individual socioeconomic status, which may not reflect each athlete's personal circumstances. Injury data was based on time-loss injuries reported to athletic trainers, so minor injuries or those managed without medical attention were not counted. Exposure time (minutes played or practiced) was not recorded, so the study could not calculate true injury rates per hour of activity. The study design is ecological, meaning it looks at group-level data and cannot prove that individual socioeconomic factors caused the injuries. There was only one year of pre-pandemic data, which limits the ability to distinguish pandemic effects from normal yearly fluctuations.
Declared interests
The text does not explicitly state funding sources or author conflicts of interest in the provided sentences, though the data was collected via the Players Health Rehab System and monitored by ATI Physical Therapy.
The easy way to misread this
Do not assume that higher income always protects against sports injuries. In the pre-pandemic year, higher-income schools had higher injury incidence. The pandemic reversed this pattern likely due to differential access to training resources, but the study cannot prove causality or rule out under-reporting of injuries in lower-income groups.