Student Athlete Health, Safety and Wellbeing: A Lack of Accountability and Prioritization Poses the Greatest Risk to College Sports
Opinion Editorial/Blog
Written by James Borchers, MD, MPH
President and CEO of USCAH
Collegiate athletics is clearly in a time of transition and evolution. The voice of the student-athlete has never been louder. The focus on student-athlete compensation, name image and likeness profitability, employment status of student athletes, and collective bargaining around issues such as media rights and data distribution rights are all dominating much of the landscape of college athletics. These are all important issues that must be considered and are being debated among leaders in college athletics, in the justice system and among legislators and constituents in the US Congress. Along with these issues, comes significant concern regarding the health, safety, and well-being of collegiate student athletes. In a recent survey of NCAA student athletes, health, safety, and well-being was identified as the number one priority for the NCAA as they revise their constitution and look toward the future. It is time that we recognize that the greatest risk to the future of collegiate athletics moving forward is a failure of prioritizing health, safety, and well-being among these other issues.
There is often a misperception regarding the resources that are available to many college student athletes with respect to health, safety, and well-being. While well-resourced colleges and universities are providing access to exceptional medical personnel, health care resources, and significant attention to both the physical and mental wellness of student-athletes, many institutions struggle to staff and resource athletic healthcare appropriately. Despite the best efforts of many institutions, there remains a disconnect in what resources are needed to address health, safety, and well-being in an athletic setting. There are four key issues that must be addressed soon for colleges and universities to meet the mission of making health, safety, and well-being truly the most important priority when it comes to collegiate athletics.
The first area that must be addressed is funding for health, safety, and well-being. Institutions often claim that health, safety, and well-being of student athletes is the primary priority in college athletics. For this to be the most important priority, significant review of revenue and resources committed to funding athletic healthcare is required and must be transparent. A lack of funding fails to prioritize both the personnel and programming needed to provide the requirements of having varsity college athletics. Funding needs to be increased for medical personnel and for appropriate programming to meet best practices surrounding college athletics. There is a misconception that this would require drastic budget increases within most collegiate athletic departments, but we must consider that the minimum investment increases risk and liability for the institutions and more importantly for the student-athletes.
The second area of focus for the health, safety, and well-being for collegiate student athletes is the personnel that are available to provide athletic healthcare. There is a developing crisis regarding a shortage among athletic training healthcare professionals that most colleges and institutions rely on for day-to-day care of student-athletes. Athletic trainers in the collegiate setting are often overworked, understaffed, and working in an antiquated model that does not allow for appropriate care of the student athlete. Athletic trainers are suffering from burnout like other healthcare professionals and are leaving the collegiate environment for other opportunities in healthcare settings. Appropriate compensation, reimagined programming, a reimagined athletic healthcare model, and improved staffing practices are places to start when addressing this crisis.
There is a growing crisis of poor mental health among college athletes. Mental health and wellness are critical components of student athlete development and success but continues to be a significant challenge for many institutions. Fortunately, emerging options such as virtual or telehealth can be solutions for institutions without adequate local resources. Ideally, student-athletes would have access to clinicians on campus or in the community for both initial and possibly second opinions. Whether for physical or mental health, the ability for student-athletes to make informed decisions about their healthcare and become advocates for their own healthcare must be a priority.
The third area that must be addressed in collegiate athletics is adherence to the principle of independent medical care. In its simplest form, independent medical care ensures medical personnel are enabled to make decisions regarding the health, safety, and well-being regarding student athletes autonomously and without interference from outside influencers including coaches, non-medical personnel, and administrators. This aligns with the principle that the reporting lines and organizational structure for athletic medical personnel should be outside of the administrative organizational structure of the athletic department. Athletic medical personnel should not report to non-medical personnel and should not be evaluated by any individual without appropriate credentials. Failure to uphold the principle of independent medical care puts student athletes at significant risk for adverse outcomes and inappropriate care.
The final area that must be addressed in collegiate athletics is the enforcement of best practices with respect to the health, safety, and well-being of student athletes. As an example, the NCAA has stated that institutions in all three Divisions must comply with the Interassociation Recommendations for the Prevention of Catastrophic Injury and Sudden Death in Collegiate Athletes, which is endorsed by 12 major sports medicine organizations as best practice for collegiate athletic departments. These recommendations focus on six areas that include sportsmanship, protective equipment, acclimatization and conditioning, emergency action planning, responsibilities of athletics personnel and education and training. While some collegiate athletic departments address these best practices, many fall short of meeting the minimum standards. Further, there is no enforcement of the standards put forth in this document, or any other student athlete health and well-being best practices. Additional examples of best practice include the opportunity for student-athletes to solicit medical information and report issues regarding health and safety outside of the athletic department. There are several “anonymous reporting” platforms in use by athletic departments, but too often the reporting goes back to department personnel and reduces a student athletes’ confidence in their ability to get an unbiased response and approach to their issue. These concerns would be best reported to an independent third party outside of the athletic department to ensure an appropriate approach to student athlete questions and concerns.
Health, safety, and well-being of student-athletes will shape collegiate athletics and the future of collegiate sports. There is no area more important with respect to safeguarding athletes and reducing risk and liability for institutions. More attention must be devoted to these issues in the future. Without intentional, proactive engagement, college athletic associations, conferences, colleges, and universities will place the future of college sports in jeopardy. College athletics provide amazing opportunities for student athletes to pursue their dreams both in athletics and education equipping them for future success. Failing to appropriately prioritize the health, safety, and well-being of student athletes in college sports puts those dreams at risk.
