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Original article
Association between community socioeconomic characteristics and access to youth flag football
  1. Emily Kroshus1,2,
  2. Aly J Sonnen3,
  3. Sara PD Chrisman4,5,
  4. Frederick P Rivara6,7,8
  1. 1 Department of Pediatrics, University of Washington, Seattle, Washington, USA
  2. 2 Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
  3. 3 University of Notre Dame, South Bend, Indiana, USA
  4. 4 Division of Adolescent Medicine, University of Washington, Seattle, Washington, USA
  5. 5 Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, USA
  6. 6 Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA
  7. 7 Department of Pediatrics, University of Washington, Seattle, Washington, USA
  8. 8 Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, WA, USA
  1. Correspondence to Dr Emily Kroshus, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA; ekroshus{at}u.washington.edu

Abstract

Background The American Academy of Pediatrics has recommended that opportunities for non-tackling American football (e.g., flag football) be expanded, given concerns about the risks of brain trauma from tackle football. This study tested the hypothesis that flag football would be more accessible in communities characterised by higher socioeconomic status residents.

Methods In July 2017, the locations of community-based organisations offering youth flag and tackle football for youth between the ages of 6 and 13 in two US states (Georgia and Washington) were aggregated (n=440). Organisations were coded in terms of the availability of tackle and/or flag football teams for youth at each year of age between 6 and 13. Multivariate logistic regression analyses were used to assess the odds of a community-based football organisation offering flag football, by community socioeconomic and demographic characteristics.

Results In both states, communities with more educated residents were more likely to offer flag football for youth aged 6–12. For example, among 6 year-olds every 10% increase in the number of adult residents with a college education was associated with 1.51 times the odds of flag football availability (95% CI 1.22 to 1.86, P<0.001).

Conclusion These results suggest that youth living in communities characterised by low educational attainment are less likely than other youth to have the option of a lower contact alternative to tackle football. Relying on voluntary community-level adoption of lower contact alternatives to tackle football may result in inequitable access to such sport options. This may contribute to an inequitable burden of brain trauma from youth sport.

  • concussion
  • public health
  • recreation / sports
  • health disparities
  • sports / leisure facility
  • socioeconomic status

https://doi.org/10.1136/injuryprev-2017-042677

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    Footnotes

    • Contributors EK and AJS participated in the concept and design; analysis and interpretation of data; drafting and revising of the manuscript. SPC and FR participated in the analysis and interpretation of data; drafting and revising of the manuscript. All authors approved the manuscript as submitted and agree to be accountable for all aspects of the work.

    • Competing interests None declared.

    • Ethics approval Seattle Children’s Research Institute.

    • Provenance and peer review Not commissioned; externally peer reviewed.