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Powell-Wiley TM, Martinez MF, Heneghan J, Weatherwax C, Osei Baah F, Velmurugan K, Chin KL, Ayers C, Cintron MA, Ortiz-Whittingham LR, Sandler D, Sharda S, Whitley M, Bartsch SM, O’Shea KJ, Tsintsifas A, Dibbs A, Scannell SA, Lee BY. Health and Economic Value of Eliminating Socioeconomic Disparities in US Youth Physical Activity. JAMA HEALTH FORUM 2024; 5:e240088. [PMID: 38488779 PMCID: PMC10943408 DOI: 10.1001/jamahealthforum.2024.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/08/2024] [Indexed: 03/18/2024] Open
Abstract
Importance There are considerable socioeconomic status (SES) disparities in youth physical activity (PA) levels. For example, studies show that lower-SES youth are less active, have lower participation in organized sports and physical education classes, and have more limited access to PA equipment. Objective To determine the potential public health and economic effects of eliminating disparities in PA levels among US youth SES groups. Design and Setting An agent-based model representing all 6- to 17-year-old children in the US was used to simulate the epidemiological, clinical, and economic effects of disparities in PA levels among different SES groups and the effect of reducing these disparities. Main Outcomes and Measures Anthropometric measures (eg, body mass index) and the presence and severity of risk factors associated with weight (stroke, coronary heart disease, type 2 diabetes, or cancer), as well as direct and indirect cost savings. Results This model, representing all 50 million US children and adolescents 6 to 17 years old, found that if the US eliminates the disparity in youth PA levels across SES groups, absolute overweight and obesity prevalence would decrease by 0.826% (95% CI, 0.821%-0.832%), resulting in approximately 383 000 (95% CI, 368 000-399 000) fewer cases of overweight and obesity and 101 000 (95% CI, 98 000-105 000) fewer cases of weight-related diseases (stroke and coronary heart disease events, type 2 diabetes, or cancer). This would result in more than $15.60 (95% CI, $15.01-$16.10) billion in cost savings over the youth cohort's lifetime. There are meaningful benefits even when reducing the disparity by just 25%, which would result in $1.85 (95% CI, $1.70-$2.00) billion in direct medical costs averted and $2.48 (95% CI, $2.04-$2.92) billion in productivity losses averted. For every 1% in disparity reduction, total productivity losses would decrease by about $83.8 million, and total direct medical costs would decrease by about $68.7 million. Conclusions and Relevance This study quantified the potential savings from eliminating or reducing PA disparities, which can help policymakers, health care systems, schools, funders, sports organizations, and other businesses better prioritize investments toward addressing these disparities.
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Affiliation(s)
- Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Marie F. Martinez
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Jessie Heneghan
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Colleen Weatherwax
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Foster Osei Baah
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Kavya Velmurugan
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Kevin L. Chin
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Colby Ayers
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Manuel A. Cintron
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Lola R. Ortiz-Whittingham
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Dana Sandler
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Sonal Sharda
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
| | - Meredith Whitley
- Ruth S. Ammon College of Education and Health Sciences, Adelphi University, Garden City, New York
- Maties Sport, Centre for Sport Leadership, Stellenbosch University, Stellenbosch, South Africa
| | - Sarah M. Bartsch
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Kelly J. O’Shea
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Alexandra Tsintsifas
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Alexis Dibbs
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Sheryl A. Scannell
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
| | - Bruce Y. Lee
- Public Health Informatics, Computational, and Operations Research (PHICOR), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Center for Advanced Technology and Communication in Health (CATCH), CUNY Graduate School of Public Health and Health Policy, New York, New York
- Artificial Intelligence, Modeling, and Informatics, for Nutrition Guidance and Systems (AIMINGS) Center, New York, New York
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Back J, Stenling A, Solstad BE, Svedberg P, Johnson U, Ntoumanis N, Gustafsson H, Ivarsson A. Psychosocial Predictors of Drop-Out from Organised Sport: A Prospective Study in Adolescent Soccer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16585. [PMID: 36554464 PMCID: PMC9779338 DOI: 10.3390/ijerph192416585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
In recent years an increased drop-out rate in adolescents' soccer participation has been observed. Given the potentially adverse consequences of drop-out from soccer, more information about risk factors for drop-out is warranted. In the current study, Classification and Regression Tree (CRT) analysis was used to investigate demographic and motivational factors associated with an increased risk of drop-out from adolescent soccer. The results of this study indicate that older age, experiencing less autonomy support from the coach, less intrinsic motivation, being female, and lower socioeconomic status are factors associated with an increased risk of drop-out. An interpretation of the results of this study is that coaches play a central part in creating a sports context that facilitates motivation and continued soccer participation. Based on the findings of the current study we propose that soccer clubs implement theoretically informed coach education programs to help coaches adopt autonomy-supportive coaching strategies.
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Affiliation(s)
- Jenny Back
- School of Health and Welfare, Halmstad University, P.O. Box 823, 301 18 Halmstad, Sweden
| | - Andreas Stenling
- Department of Psychology, Umeå University, 901 87 Umeå, Sweden
- Department of Sport Science and Physical Education, University of Agder, 4630 Kristiansand, Norway
| | - Bård Erlend Solstad
- Department of Sport Science and Physical Education, University of Agder, 4630 Kristiansand, Norway
- Norwegian Research Centre for Children and Youth Sports, 0806 Oslo, Norway
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, P.O. Box 823, 301 18 Halmstad, Sweden
| | - Urban Johnson
- School of Health and Welfare, Halmstad University, P.O. Box 823, 301 18 Halmstad, Sweden
| | - Nikos Ntoumanis
- School of Health and Welfare, Halmstad University, P.O. Box 823, 301 18 Halmstad, Sweden
- Danish Centre for Motivation and Behaviour Science, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
| | - Henrik Gustafsson
- Department of Educational Studies, Karlstad University, 651 88 Karlstad, Sweden
- Department of Sport and Social Sciences, Norwegian School of Sport Sciences, 0863 Oslo, Norway
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, P.O. Box 823, 301 18 Halmstad, Sweden
- Department of Sport Science and Physical Education, University of Agder, 4630 Kristiansand, Norway
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Gredin NV, Back J, Johnson U, Svedberg P, Stenling A, Solstad BE, Ivarsson A. Exploring psychosocial risk factors for dropout in adolescent female soccer. SCI MED FOOTBALL 2022; 6:668-674. [PMID: 36540913 DOI: 10.1080/24733938.2022.2088843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We examined the manner in which age, participation in other sports, socioeconomic status, perceived sport competence, achievement goal orientations, and perceived motivational climate may interact to predict the risk of dropout among adolescent female soccer players. METHODS Self-reported data from 519 female soccer players between 10 and 19 years of age (M = 13.41, SD = 1.77) were analysed using a person-centred approach to uncover the interactions among risk factors and their relative predictability of dropout. RESULTS Perceived motivational climate was identified as the main predictor, where relatively lower levels of mastery climate were associated with a higher dropout tendency (absolute risk reduction [ARR] = 12.2% ±6.1% [95% CL]). If combined with relatively lower levels of mastery climate, then relatively lower levels of perceived sport competence were related to higher dropout risks (ARR = 16.5% ±9.5%), whereas, in combination with relatively higher levels of mastery climate, then relatively lower levels of ego-orientated achievement goals were associated with higher dropout rates (ARR = 10.8% ±12.6%). CONCLUSIONS Our findings afford novel insights into the interactions between, and the relative importance of, various risk factors for dropout in adolescent female soccer. This knowledge may be useful for soccer associations, clubs, and coaches when developing guidelines and strategies that aim to foster young females' sustained participation in organised soccer.
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Affiliation(s)
- N Viktor Gredin
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Jenny Back
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Urban Johnson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Andreas Stenling
- Department of Psychology, Umeå University, Umeå, Sweden.,Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Bård Erlend Solstad
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.,Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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de Borja C, Chang CJ, Watkins R, Senter C. Optimizing Health and Athletic Performance for Women. Curr Rev Musculoskelet Med 2022; 15:10-20. [PMID: 35023069 PMCID: PMC8804053 DOI: 10.1007/s12178-021-09735-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The exponential growth of women participating in competitive sports throughout the years was made possible through several initiatives by the International Olympic Committee and the passage and implementation of Title IX as a federal law in the United States. However, this positive trend towards gender equity in sports has not transpired for women in medicine, especially in fields that care for elite athletes. This current review will discuss specific areas that can be tailored to help female athletes prevent injuries and optimize their athletic performance. We will also highlight how increased female team physician representation in sports may help optimize care for female athletes. RECENT FINDINGS Female athletes are considered high risk for certain conditions such as ACL tears, patellofemoral pain syndrome, bone stress injuries, sport-related concussions, and sexual violence in sport. Addressing factors specific to female athletes has been found to be valuable in preventing injuries. Strength and conditioning can optimize athletic performance but remains underutilized among female athletes. Although diversity in healthcare workforce has been found to be beneficial for multiple reasons, women remain underrepresented in sports medicine. Increasing female team physician representation may positively impact care for female athletes. Team physicians must understand the physiologic, biomechanical, and anatomic factors that are unique to female athletes in order to tailor injury prevention programs and optimize their athletic performance. Advocating for gender equity in sports medicine to advance representation of women in the field will increase workforce diversity and promote excellence in sports medicine care.
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Affiliation(s)
- Celina de Borja
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, 1825 4th Street, 5th Floor, San Francisco, CA, 94158, USA.
| | - Cindy J Chang
- Department of Orthopaedic Surgery, Primary Care Sports Medicine, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Rhonda Watkins
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, 1825 4th Street, 5th Floor, San Francisco, CA, 94158, USA
| | - Carlin Senter
- Department of Orthopaedic Surgery, Primary Care Sports Medicine, University of California, San Francisco, San Francisco, CA, 94158, USA
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