A new study by the Korey Stringer Institute reports that only one in three high schools in the United States has access to an athletic trainer (AT) despite proven evidence that athletic trainers improve injury prevention. In private schools, this number is even less.

The study, “Athletic Trainer Services in the Secondary School Setting: The Athletic Training and Locations Services Project (ATLAS)” was published in the Journal of Athletic Training, the scientific publication of the National Athletic Trainers’ Association (NATA).

According to the data collected, of the 20,272 secondary schools identified, 66% of the schools (13,473) had access to athletic trainer services which was defined as receiving services in any form by a licensed or certified AT, while 34% (6,799) had no access.

In addition, of those schools with access to AT services, 53% (7,119) received full-time services, considered the gold standard of care, while 475 (6,354) only received part-time services. The researchers also compared access in public schools vs. private schools and found that 37% of public schools had full-time services while 27% of private schools had the same type of service.

“Despite an increase in the number of legal cases, court-ordered overhauling of health and safety policies and awarding of large settlements, school districts, school education boards, state legislators and state athletic associations continue to take a reactive, rather than proactive, approach to addressing safety concerns,” lead author Robert Huggins, Ph.D., LAT, ATC said.

“Providing appropriate care for student athletes comes down to priorities. The safety of student athletes must be the top priority for schools with athletic programs, not just in rhetoric, but in allocation of resources to put the appropriate personnel in place,” said NATA President Tory Lindley, MA, ATC.

“Schools need to see athletic trainers are an essential requirement to having an athletics program—similar to how they see the coach. While coaches oversee play on the field, athletic trainers are responsible for injury prevention and addressing the physical and mental effects of playing the game. Athletic trainers should not be a luxury but rather a necessity for all programs.”

According to the study authors, often cited challenges to hiring athletic trainers include budget limitations, school size, remote location of the school and a lack of awareness of the importance of the athletic trainer’s role.

The data for this study was gathered by phone or email from September 2015 to April 2018 from communications with school administrators or ATs. Some information was also collected from online surveys of secondary school ATs.