FAMILY AFFLUENCE RELATIONSHIP TO SPORTS SPECIALIZATION IN YOUTH ATHLETES
Authors: Walker Gregory A. , Armento Aubrey , Dahab Katherine S. , Provance Aaron J. , Wilson Julie C. , Howell David R. 
Published: April 2020

Background: Specializing in a single sport while excluding others, also known as sports specialization, is increasing in prevalence in the United States. The effect of socioeconomic status (SES) on rates of sports specialization has been previously described in the specialty clinic setting using zip code as a surrogate for SES. Patient-reported family affluence, a validated surrogate for SES, may provide more specific information about how family SES is associated with sport specialization. Purpose/Hypothesis: Our purpose was to examine the association between patient-reported SES and sport specialization level. We hypothesized that athletes who reported higher levels of sports specialization would report greater family affluence. Methods: We conducted a cross-sectional study of youth athletes undergoing a pre-participation evaluation. During the assessment, participants specified their level of sport specialization on a 3-point scale described originally by Jayanthi and colleagues. Participants also completed the Family Affluence Scale, a 6-item scale which is a valid correlate of parental income. We compared family affluence among the sport specialization groups (low/medium/high) using ANOVA with Tukey post-hoc comparisons. We then constructed a multivariable linear regression model to assess the association between family affluence and sport specialization level while controlling for potential confounding variables. Results: A total of 195 youth athletes participated in the study. The majority (52%) reported low levels of sport specialization, 33% reported medium sport specialization, and 15% reported high sport specialization. The sport specialization groups were similar in age, proportion of females, and time spent training in their sport (Table 1). A significantly larger proportion of highly specialized athletes were varsity athletes compared to the low specialization group (Table 1). The high sport specialization group reported significantly greater family affluence than the low sport specialization group (Figure 1). After covariate adjustment, higher levels of sport specialization remained significantly associated with greater reported family affluence (Table 2). Conclusion: In our population of youth athletes, high sports specialization was associated with greater family affluence. Additionally, we found a significantly higher proportion of varsity level athletes in the high sports specialization groups. This study extends previous studies identifying greater sports specialization levels among those with higher SES. By using the Family Affluence Scale and sampling from a large and diverse population during a pre-participation evaluation, our findings reflect accurate patient-level associations. Examining SES and sports specialization affords the sports medicine community an opportunity to better identify and monitor populations who are likely to specialize in a single sport during high school. [Table: see text][Figure: see text][Table: see text]