Disparities Research in Sports Medicine Lacks Qualitative Studies, Community Engagement, and Original Interventions

Across the health care landscape, patients experience disparities based on insurance, sex, gender, race, and other determinants. Such findings have been reported in orthopaedic sports medicine; nonetheless, the overall quality of the literature, including its limitations and impact, is unknown. Understanding this will allow researchers to address areas of need and ultimately reduce disparities.

To explore trends in orthopaedic sports medicine disparities research, with attention to study design, community engagement, and the development of interventions.

Scoping review; Level of evidence, 3.

The Clarivate Web of Science platform was queried for English-language articles in the orthopedics and sports sciences categories between 2013 and 2022 with the following keywords: "disparities,""disparity,""inequity,""inequities,""diversity,""socioeconomic,""sex,""gender,""insurance,""race," and "neighborhood." Abstracts were reviewed manually to determine study inclusion. Bibliometric data were collected, as was information on the area of focus, study design, determinants of interest, funding sources, and intervention design. Descriptive statistics were recorded.

The query yielded 7274 articles, of which 86 addressed disparities or diversity topics in sports medicine. A total of 57 (66.3%) articles were published between 2019 and 2022, and 24 (27.9%) were published in 2022. Predominant journals included the Orthopaedic Journal of Sports Medicine (23.3%) and the American Journal of Sports Medicine (12.8%). Also, 29 articles (33.7%) focused on anterior cruciate ligament (ACL) injuries, and 12 (14%) on rotator cuff tears. Of the 80 observational research articles, the majority (63.8%) were retrospective, and there was a lack of randomized controlled trials or qualitative/mixed methods designs. No studies primarily utilized a community-engaged approach. A total of 31 publications (36%) studied multiple determinants or descriptive data, while 30.2% focused on sex or gender, and 18.6% on insurance. Only 2 (2.3%) studied neighborhood factors. Notably, only 1 study focused on an intervention. Further, only 3 studies (3.5%) were supported directly by the National Institutes of Health funding.

This study provides insights into the evolving landscape of sports medicine disparities research. Although the volume of this research has increased substantially in recent years, the literature consists mostly of retrospective studies with a lack of qualitative methodology, community engagement, and development of interventions to reduce disparities. These findings highlight areas for future research.