Introduction
Sports athletes due to the nature of their activities are often faced with a variety of both occupational diseases and injuries that seem to have short-term consequences to health. One of the health issues that has been underestimated in its consequences to health is a concussion. This health problem is widespread among football athletes in particular. Thus, per 100000 football athletes, almost 77% of players are exposed to concussions.
This problem has become more evident and critical during the last years, and it is now researched more comprehensively. It is crucial to note that earlier the concussion was perceived as causing short-term functional problems such as memory loss or impaired concentration (Solomon, Ott, & Lovell, 2011). However, athletes, healthcare professionals, and the society, in general, are becoming increasingly aware that concussion entails structural damage to the brain, in particular, to the thin fibers of nerve cells, called axons, which are located deep inside the brain.
Moreover, the criticality of the situation is reflected in the fact that many people believe that a concussion can be obtained as a result of a serious collision solely, but it is not so. The researchers argue that only 10% of concussions are accompanied by the loss of consciousness. Concussion has a number of symptoms, yet it is often neglected. It is necessary to state that football athletes experiencing concussion are exposed to an increased risk of further injury and detrimental effects on health status.
Population
The paper researches the football athletes aged 20-39 years since it is believed that they are at a higher risk of suffering from concussion and experiencing long-term consequences to health further on (Solomon et al., 2011). Despite the fact that the environmental scan was done in a specific region, the academic research evidence that this situation is typical for many countries and regions. For instance, in such countries as Canada, America, and some of the European countries concussions are the leading cause (in more than 60%of cases) for health complications in football athletes and they often remain either neglected or undiagnosed, which is a worrying sign (Hollis et al., 2011).
Hence, this health care issue proclaims the existing gap between the health care issue that is urgent and the appropriate response by the government, the society, and sports bodies to address the issue in a sufficient way.
Health Issue
Despite the fact that many athletes perceive concussion as a minor problem, it is essential to emphasize that regular concussions can lead to serious brain damages and, consequently, to violations of the cognitive functions in the long-term (Solomon et al., 2011). For instance, scientists have defined the effects of a concussion such as memory loss, perceptual disorders, uncontrollable mood swings, and so on. However, until recently, large-scale research in this area has not been conducted, and the relevant system of indicators to assess the state of the players after the concussion does not exist (Leddy, Baker, Kozlowski, Bisson, & Willer, 2011).
Head injuries in football raise attention when the player has a skull fracture or bleeding. However, the earliest studies in the area revealed that nearly 8% of the players were constantly experiencing minor concussions during matches and training. The latest studies have shown that more than half of the athletes experience headaches for at least five days, which is one of the signs of concussion. A quarter of all players experiences memory problems, nausea, and dizziness.
It is crucial to note that concussions are perceived as micro-trauma from the part of coaches, assistants, and players. Nonetheless, they may have a negative impact on the brain of the athletes (Barr, Prichep, Chabot, Powell, & McCrea, 2012). At present, the list of concussion symptoms is long enough. For example, headaches, seizures, memory loss, and visual disturbances are among the typical symptoms, but the most common is a headache. The symptoms can last for hours and even days after the injury. Many athletes and representatives of the sports industry do not perceive it a serious threat to the health; thus, the brain of athletes is subjected to degenerative changes that are more serious, and this is the greatest difficulty and danger (Lehman, Hein, Baron, & Gersic, 2012).
Analyzing the statistics, the chronic traumatic encephalopathy (CTE) or concussion is a common neurological disorder that affects many former football athletes. In different countries, different practices have been developed with respect to this health issue. For example, in America, the financial aid for football players with identified serious neurological disorders equals approximately 5 million USD. With CTE such consequences can also develop.
In this relation, the most serious consequences are unmotivated aggression and dementia (the disintegration of mental functions due to brain injury) (Vagnozzi et al., 2010). However, such a diagnosis can be confirmed by autopsy in the majority of cases. Over the past decade, there have been many occasions when athletes have sued clubs and associations for such health complications. For example, about 20 thousand former professional football players filed a class-action lawsuit. As a consequence of that, the league has removed the restriction on the total amount of the final payment. However, the growing number of complaints indicates that the preventive measures of concussion are needed.
SDOH
It is worth noting that the social determinants of health (SDOH) are a comprehensive paradigm, which allows describing a health issue from different perspectives. Determinants are not limited to the conditions of people’s living, but they also define the setting in which they operate.
The favorable or unfavorable circumstances are influenced by factors such as the distribution of power, money, and resources. Regarding the target population, which are the football athletes aged 20-39, the primary source of influence is the policy of the state and the sports organizations’ of all scales (Baillargeon, Lassonde, Leclerc, & Ellemberg, 2012). Thus, the social determinants of health are the main causes of health inequities in this context.
To be more precise, there are three key SDOH issues that influence the population group the most. They are individual factors, social factors, and gender. It should be noted that the first factor is directly linked to the unequal distribution of financial resources, especially in the cases of professional and amateur football athletes. The researchers claim that elite players are secured by various financial and medical means, which is not characteristic of the players of the lower leagues.
In addition, the majority of players of the younger age (starting from 20) do not have sufficient knowledge of concussion and its consequences though already experiencing its effects on their health (Mitka, 2010). Moreover, many of them come to the senior leagues while having health complications, which means that effective concussion preventive measures are not taken at the amateur levels. It implies that senior football athletes (aged 25 and older) have to manage the effects on health due to improper policies rather than being secured from the very beginning of their careers (Kimbler, Murphy, & Dhandapani, 2011).
In addition, the age of athletes plays a major role in this health issue since younger players do not possess enough financial sources to purchase the protective equipment and they are not knowledgeable enough about the unsafe practices. According to the researches examining different age groups of athletes, the majority of the population aged 20-23 were not aware or had erroneous beliefs about the potential causes of injury (Halstead & Walter, 2010). That is to say that the percentage of young athletes exposed to concussions was approximately 70-76% compared to the older sportspersons aged 30-39.
The social factor also depends on a variety of aspects. For instance, scientists evidenced that athletes from poorer regions or communities were more exposed to concussions due to the insufficient protection and low concern of the coaching staff. The unequal distribution of sources facilitates diverse conditions for training and conducting matches. In particular, almost 80% of concussions are gained during group working out or training.
It means that poorer settings tend to have a detrimental effect on the awareness and contribution of the coaching staff, assistants, and even the medical team. All of that results in the emergence of greater exposure of the younger players to concussion (Lincoln et al., 2011). In this matter, it should be stressed out that age is also indeed important. One of the studies conducted during the past five years revealed that younger athletes might experience stronger consequences to health compared to those aged 30 and older. Therefore, younger athletes should be paid increased attention, and more resources should be allocated to provide sufficient training opportunities for football athletes (Lincoln et al., 2011).
The third SDOH that has a great impact on this health issue specific to the target population is gender. It is worthy of mentioning that the majority of teams are for men. One of the researches showed that men are four times more likely to be injured since they are more susceptible to adrenaline rush under the effects of which they can become more unguarded. That is to say, male athletes, especially those aged 20-27 are more likely to experience concussions.
Recommendations
To achieve the best results, the measures should be implemented at different levels, at the community level, and at the state level as well. The two strategies that can make a difference in this health issue are the community-based interventions and increasing the awareness of the population of the consequences and threats of concussions. To improve the health status and tackle inequities, it is necessary to ensure fair access to health care (Grady, 2010).
In the absence of medical care, many changes for fundamental health enhancement are absent. Speaking of the young athletes, it is necessary to analyze the system of care and prevention of concussions covering the entire population regardless of their ability to pay. It is necessary to provide coverage of the protection systems of those who have precarious conditions for training and inadequate conditions for conducting competitions.
Focusing on the three social determinants of health described above, the inequitable distribution of power, money, and resources should be addressed. Moreover, it is crucial to assess the existing problems and the impact of measures taken. As mentioned previously, the sports organizations do not have the appropriate policies with respect to concussions and the initial step to solving the problem will be to forbid football athletes to play if there are any suspicions of concussion (Grady, 2010). Both the local and national communities should undertake this policy in the aftermath. In particular, the directions to overcome the inappropriate conditions that are determined by SDOH will create fair opportunities for a healthy and safe lifestyle and activities.
The second strategy is the education of the population. This is one of the most important determinants of health in regards to the fact that the level of awareness determines mortality and morbidity. In general, it is necessary to establish an inter-agency mechanism to ensure a coherent policy and to create a comprehensive program of quality initiatives for all athletes.
Community Health Nurse Role
The role of the nurse in this question is essentially diverse. The CHN should perform both preventions of concussion through education and serve as an advocate for the population on the higher authority level through promoting the corresponding policies (Competencies, 2014). The health care practitioner should educate all the parties involved in the football activities including coaches, players, assistants, and medical teams about the symptoms and signals of concussions and raise their awareness of the activities increasing the risks of injury (Working in different roles, 2009).
CHNs should provide the referral to the appropriate services if the athletes of the community are not knowledgeable about the places where they can get the help of support if they consider the actions of one of the parties incorrect. For instance, if a coach justifies continuing to play when the athlete has any worrying signs by the financial or any other interest. In particular, more advanced athletes are more susceptible to pursuing the money benefit, this way putting their health at risk; thus, it is required to inform all of the population groups about the possible consequences to health (Kutcher & Eckner, 2010).
Regarding the community-level interventions, CHNs can advocate for a healthy environment and policies by promoting the practices that are safer (Nurse practitioner, 2016). In addition, they can propose their suggestions for improvements to the community concussion policy. It is advisable that health care specialists take an active part in expanding the existing protocols for concussion and keep track of their implementation (Grady, 2010). Thus, by being the population advocates, nurses will provide both the educational services and execute autonomy and leadership in facilitating better environment and conditions for the athletes.
Conclusion
Thus, the football athletes aged 20-39 years are at a higher risk of suffering from concussions and experiencing long-term consequences to health. CTE can occur during matches, practices, and other athletic exposures; however, as per the research results, not many organizations have the corresponding policies to address this critical issue. Consequently, the community-based interventions and raising the awareness of the population of the consequences and threats of concussions should be the two approaches to respond to the health issue faced by this target group. Following the holistic approach will ensure higher awareness and bring the attention of the respective bodies to this problem.
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