The Louisville Courier-Journal has recently published a database – Deadly Games – chronicling student athletes' tragic, and unfortunately common, deaths. The database helps bring awareness of the magnitude of inadequate athlete welfare protection while highlighting the real experiences of these players – these are people, not just statistics, facts, medals, or numbers on a team. These are real athletic participants who died because of largely preventable issues.
At least 200 middle and high school athletes have died within the past 10 years, with sudden cardiac arrest being the most common cause of death among student-athletes. Other common causes of death for student-athletes include heat stroke, drowning, traumatic brain injury, and pulmonary embolism.
There are certain commonalities seen in student-athlete deaths. One common factor related to causation is exertion – many student-athlete deaths are a result of overexertion or conditions like exertional heat stroke and exertional sickling. When examining sudden cardiac arrests, many athletes who experience them have pre-existing heart conditions, such as cardiomyopathies. These conditions may not show up when athletes are examined for physicals and may be triggered by rigorous athletic training and competition.
The tragic deaths of student-athletes have been highlighted in recent news. Less than a month ago, a teenager in New Zealand died after sustaining a traumatic brain injury playing a rugby-inspired tackle game. The game called the “run it straight” challenge, has been promoted online by professional rugby players, even as critics voiced concern about the challenge’s head injury risk.
A football player at Bucknell University died in July 2024 as a result of exercise collapse associated with sickle cell traits. He had been diagnosed with sickle cell trait before college after undergoing mandatory NCAA athletic testing but was considered relatively healthy otherwise. After a grueling hazing activity involving overexercise enforced by a strength and conditioning coach, he contracted exertional rhabdomyolysis and died. The school was aware of his condition and (allegedly) of the hazing perpetrated by that coach.
In Houston, Texas, there was a recent death of a minor athlete that was entirely preventable due to a lack of medical staff and adequate medical equipment. While Texas law requires that all schools have AEDs and medical staff certified to use them, the defibrillator allegedly did not work on the student after he collapsed after practice. In north Texas, a teenage swimmer drowned while warming up for swim practice. Her coach briefly left the pool to refill her coffee, and the athlete drowned within minutes in a pool full of her teammates.
Some of these deaths have sparked meaningful change in how we mitigate death risk in athletics. As a result of the Houston athlete's death, ten different bills were introduced to improve emergency response policies across all Texas schools. This is an excellent responsive step in the right direction, but we all need to do better to proactively protect our athletes' holistic well-being.
Sports are commonly viewed as safe spaces where nothing negative can occur, which unfortunately isn’t always the case. As mentioned in the article, sudden cardiac arrest occurs every three days during the school year. The statistics regarding abuse and misconduct in sport are equally staggering – more than 50% of athletes experience abuse or misconduct before the age of 18. In schools specifically, coaches are perpetrators in ⅓ of all child sex abuse cases. The Courier Journal tackled this issue in the Silence and Secrets Investigation, which revealed at least 80 incidents of child sexual misconduct perpetrated by middle and high school coaches in Kentucky within the past 15 years.
Many of the deaths exemplified in the Deadly Games database are a result of preventable issues, including inadequate supervision, overtraining, and heat exhaustion. Abuse in athletics is equally preventable, as we can mitigate the risk of abuse through education, awareness, and policy standardizing acceptable versus unacceptable behavior. However, if these policies are not implemented and followed with fidelity by schools and educators, abuse can occur with passive permission.
This is why it’s so important that we engage in proactive abuse prevention and provide holistic support to athletes. Holistic support encompasses safeguarding and includes physically safeguarding athletes by meeting athletes' physical and medical needs sufficiently and appropriately to protect athletes in the short and long term.
We can ensure our athletes’ physical environments and medical needs are adequate and safe.
For example, districts should perform routine risk assessments to evaluate where abuse and deaths may take place and reduce these risks. Those directly working with athletes should consider environmental factors (such as open water, or inclement weather) that might impact risks.
Prevention is a medicine best dosed early and often, and the provision of simple and tangible educational material goes a long way. We teach children basic public health prevention measures frequently in the form of small actionable steps: things like washing hands to prevent the spread of germs, “stop, drop, and roll”, and tornado drills. We can similarly educate athletes on issues of abuse and death.
Most importantly, we need to listen to the needs of our athletes and understand where they need support the most. We have to empower athletes to vocalize when they feel uncomfortable, injured, or ill. We must have these necessary conversations to decrease stigma and raise awareness.
If you or someone you know needs support, please visit our crisis resources or resources for assistance.
Annelise Ware, MHS
Program Manager at #WeRideTogether
aware@weridetogether.today
