Research Report: Health Risks and the Teen Athlete (page 5)

Athletes Were Less Likely To Use Illicit Drugs. Playing sports was associated with reduced risk for illicit drug use.

Key findings include:

1. Athletes Were Less Likely To Use Illicit Drugs.

Playing sports was associated with reduced risk for illicit drug use. Female athletes were less likely than female nonathletes to use marijuana, cocaine, or “other” drugs (such as LSD, PCP, speed, or heroin). Male athletes were less likely than male nonathletes to use marijuana, cocaine, crack cocaine, inhalants, or “other” drugs.

2. Findings On Anabolic Steroids Were Mixed.

Male athletes overall were no more likely to use anabolic steroids than male nonathletes were. Female athletes overall, and highly involved male athletes, were both nearly one and a half times more likely than their nonathletic counterparts to use steroids; and highly involved female athletes were nearly twice as likely to do so. However, only about 2% of teenage girls used anabolic steroids overall.

3. Only Highly Involved Athletes Were More Likely To Binge Drink.

Contrary to popular belief, neither female nor male athletes were significantly more likely than nonathletes to drink alcohol overall, or to drink to excess. However, highly involved athletes of both genders were somewhat more likely to binge drink than nonathletes.

4. Athletes Were Less Likely To Smoke Cigarettes, But More Likely To Use Chewing And Dipping Tobacco.

Athletes were less likely than nonathletes ever to have smoked cigarettes regularly or to have smoked within the past month. However, both male and female athletes were more likely to use chewing/dipping tobacco; in fact, highly involved female athletes were more than three times as likely to do so as female nonathletes. Only about 2% of teenage girls used chewing/dipping tobacco overall.

5. Athletes Were Less Likely To Be Suicidal.

Both female and male athletes were less likely than their nonathletic counterparts to seriously consider or make a plan for committing suicide. Male athletes were also less likely than male nonathletes to actually attempt suicide. However, highly involved athletes of both genders who do attempt suicide were nearly twice as likely as suicidal nonathletes to require medical treatment as a result.

6. Female Athletes Had More Positive Body Images, But Were More Likely To Attempt Weight Loss.

Both female and male athletes were less likely than nonathletes to describe themselves as overweight. However, female athletes were more likely to try to lose weight; and though they were more likely than nonathletes to use dieting and exercise to do so, highly involved female athletes were also more likely to use vomiting and/or laxatives to lose weight.

7. Female Athletes Were More Likely To Wear Seatbelts, But More Likely To Drive After Drinking.

Findings regarding the relationship between athletic participation and vehicular risk were mixed. Female athletes were a third more likely than nonathletes to wear seatbelts. Female athletes overall, and highly involved athletes of both genders, were also more likely to drive an automobile after drinking than nonathletes.

Our results show that athletic participation has both positive and negative implications for adolescent health in America today. In order to guide athletes, coaches, parents, and communities to better use sports as a means of promoting adolescent health, a list of policy recommendations follows.

Policy Recommendations

The Women’s Sports Foundation developed the following policy recommendations in order to promote the health of adolescent athletes, especially girls. Given the widespread interest and involvement of American teenagers, high school and community sport are appropriate social settings in which to plan and implement community health interventions. A panel of leaders from education, government, public health, women’s health organizations, and sport was created to review the findings from this study and to identify policy goals. We gratefully acknowledge their expertise. The list of panel members and affiliations appears in the acknowledgments in the beginning of this report. The Women’s Sports Foundation Report: Health Risks and the Teen Athlete suggests that sport is a health asset in many young people’s lives, fostering wellness and reducing certain risky behaviors. Yet some findings also point to areas where the sports experience may jeopardize the health of girls and boys. The policy recommendations below, therefore, discuss the preventive aspects of high school and community sports as well as areas in need of reform.

Promoting Adolescent Health Through Sports

1. Create Federal, State, and Local Policy and Action Agendas to Support Athletics.

Educators and local, state, and federal policy officials need to evaluate the status of high school and community sports in their domains. Many school districts are experiencing the erosion of high school sports programs, a dwindling of public resources, and a decrease in athletic opportunities. In particular, poorer neighborhoods often lack the resources to support local teams.

• Create a national policy for the protection and enhancement of high school and community sports in the United States of America.
• Both public and private funds should be provided to promote health advocacy through sport.

2. Use Sport as a Gateway to Adolescent Wellness and Long-Term Health Promotion.

Families, educators, parent-teacher associations, community organizations, and health professionals must evaluate and monitor the extent to which athletic programs protect and promote the health of teen athletes. Furthermore, the lifestyle choices and health habits that teenage athletes adopt affect their health later in life, promising not only better quality of life but significant savings in health care costs.

• Proponents of adolescent health should develop health-related educational materials specifically for athletes.
• Public health departments should emphasize sport as an avenue to health (and thus as a strategy to lower cumulative health care costs).

3. Form New Partnerships to Pursue Health Advocacy through Sport.

In order to foster adolescent health through sport, new partnerships should be forged between agencies, organizations, and institutions that are both governmental and nongovernmental, health-related and nonhealth-related, public and private.

• Public health departments, schools and universities, medical centers, various sport organizations, coaches associations, and parent associations should work together to focus public attention on, and generate public and private funding for health advocacy through sport.
• Women’s health advocates and organizations, in particular, should explore policies and programs that seek to enhance girls’ health through athletic participation.
• Men’s health researchers and advocates should do likewise for boys.

4. Promote Gender Equity in Athletics.

Historically, women’s athletic participation rates mushroomed during the 1980s and 1990s, and sports are now central to many girls’ and women’s lifestyles. However, the lack of gender equity in many school athletic programs still deprives many girls of the opportunity to pursue wellness through sports participation. Athletic programs should be supported for interested girls as well as boys.

• Title IX must be vigorously enforced at all levels of education.
• Parents, coaches, and communities should monitor school and community athletic programs, and lobby their schools and local governments to enforce gender equity.
• Lawyers, educators, epidemiologists, nurses, and school administrators can ensure that the current debates around gender equity in sports include a discussion of the ways that sports can promote greater levels of wellness in both girls and boys.

5. Foster Working Relationships Between Coaches, Parents, and Health Professionals.

Information about the health needs and risks of adolescents should be included in coaching certification and education programs. Workshops, published materials, and videos can help coaches and parents better understand the preventive potentials of athletic participation.

• School districts, community-based athletic programs, and sports governance organizations should require that athletic directors, coaches, and athletic trainers learn to better assess the health risks of adolescent athletes.
• Coaches and sports officials should work closely with school nurses, physicians, and counselors to form a network of knowledgeable adults upon whom athletes can rely for guidance, support, and intervention when needed.
• Health professionals should establish dialogue with athletes and create workshops with coaches and parents, each of whom can offer valuable insights and recommendations drawn from their unique opportunities to observe and guide adolescent athletes.
• Parent Teachers Associations, school boards, and community youth programs need to ensure that the education and health are the key organizing principles for developing and evaluating athletic programs.

6. Welcome All Interested Adolescents into High School and Community Sports.

In light of the potential health benefits associated with sport, school and community sports programs should not be reserved for only the best trained and most physically mature athletes. Sports should be made an inclusive and supportive environment for all girls and boys to develop physically, mentally, and socially.

• The increasingly competitive focus of adolescent sports (as exemplified by the excessive practice of “cutting” children and adolescents from sports teams) should be de-emphasized.
• School and community leaders must ensure that adolescent health is not compromised by cultural pressures to “win at all costs.” Instead, the potential of sport to promote fitness and personal development should be exploited.

Reducing Health Risks In Adolescent Sports

1. Acknowledge the Existence of Health Risks.

The first step to reducing the risk of behaviors with negative health consequences is to recognize the frequency with which they occur. This report has explored the prevalence and likelihood of a variety of health-risk behaviors in athletes, but much more research is needed. And more information is not enough; parents, policymakers, coaches, and athletes themselves need to talk frankly about the problems associated with adolescent sports before strategies can be crafted to resolve them.

2. Increase Efforts to Detect and Prevent Health Risk Behaviors.

High schools should develop risk management procedures that allow school health officials, administrators, and coaches to identify and deal with problem behaviors among athletes. Such programs will be most effective when interested parties within and outside the school setting establish reliable lines of communication in order to coordinate efforts to promote teen health.

3. Provide Positive and Healthy Adult Role Models.

Adolescent athletes learn by observation. Respected professional and college athletes can help to make sport a safer place for girls and boys by modeling substance-free lifestyles, responsible vehicular behavior, and nonviolence off the field, track, or court. In addition, they should refuse to advertise addictive substances. Both female and male professional athletes should be recruited to participate in public service advertising campaigns that link healthy lifestyles with sports. It is particularly important for coaches to act as positive role models for the teenagers whose lives they influence. Schools can also organize mentoring programs in which “team mentors” are used to promote the concept of healthy living through sports, and offer support and encouragement to teams.

4. Let Teens Help Each Other.

Many adolescents are inclined to reject adult advice regarding health risks. In part because of this developmental tendency, teens are often strongly susceptible to peer pressure to engage in risky behavior. While parents and coaches can and should reach out to kids, teenage athletes can also be empowered by developing peer health education and support programs under the mantle of school and community sports organizations.

5. Challenge the Use of Sport Imagery to Sell Harmful Substances to Teens.

Adolescent health advocates and proponents of high school and community sports should challenge the use of sports imagery to market dangerous substances to teenage audiences. For example, corporate advertisers regularly employ glamorous images of risk sports to sell tobacco and alcohol products. The symbolic masking of addicting drugs behind the facade of athletic excitement distorts many healthful sporting values while elevating the risk of adolescent experimentation. Sports magazines and television programming with substantial teen audiences should be encouraged to eliminate tobacco and alcohol advertisements.

6. Pay Close Attention When Depressed Athletes Talk About Suicide.

Although participation in sports is associated with lower rates of considering, planning, or attempting suicide, those teen athletes who do try to kill themselves are more likely to cause serious bodily harm. No teen who expresses suicidal thoughts should be ignored, but athletes in particular should receive prompt intervention. Because athletes often grow close to their coaches and seek their advice on non-sport-related matters, coaches and health professionals can work together to supplement parental and school efforts along these lines.