Status Of Athletic Health Care In Hawaiʻi's High Schools

Abstract

In 1997, Hawaii became the first state to mandate National Athletic Trainers' Association (NATA) Board of Certification (BOC) certified athletic trainers (ATC) in all public high schools. In 1991, only seven ATCs were employed in five private schools in Hawaii representing ATC to athlete ratios of 1:1,000 in private schools (PRIS) and 0: 13,000 in public schools (PUBS). Currently approximate high school ATC to athlete ratios in Hawaii and the nation are 1:600 and 1:700, respectively. Therefore, the purpose of this study was to investigate how the placement of NATABOC ATCs in all State of Hawaii public high schools has impacted the identification of athletic injuries and ATC to athlete ratios. Additionally, comparisons between public and private schools were made. Surveys were mailed to 78 high school athletic directors and 52 high school ATCs. Survey return rates were 71.5% (93/130) overall, 76.7% (66/86) PUBS and 64.3% (27/42) PRIS. Survey results indicated that there were over 60,000 students enrolled in high schools in Hawaii, with nearly 24,000 involved in athletics (15,284 [64%] PUBS and 8,698 [36%] PRIS). A total of61 ATCs were employed by the schools surveyed (37 PUBS and 24 PRIS). The PUBS had an ATC to athlete ratio of 1:390 compared to 1:355 in PRIS. The majority of schools (both PRIS and PUBS) employed one ATC; however, two PRIS employed three ATCs each. Public school and PRIS athletes sustained 64% and 36% of the 38,000 injuries reported in 1995-2000, respectively. Yet, when calculating the total number of injuries by total athletes, injury rates of 1.53 (23,565 injuries/15,217 athletes) for PUBS and 1.35 (13,246 injuries/8,528 athletes) for PRIS were obtained. Only 59% of the PRIS schools had ATC positions compared to 97% of the PUBS schools that had ATC positions.