A comprehensive new analysis published in the Lancet, led by Dr. Jonathan Kim, a sports cardiologist at Emory, reveals that Black athletes are about five times more prone to sudden cardiac arrest (SCA) and sudden cardiac death (SCD) than their White counterparts. This finding comes despite some indications that SCD rates overall may be decreasing. Historically, SCA and SCD have been key contributors to athlete fatalities, especially in high-intensity sports.
The differences in SCA/D rates underscore the urgent need for more research into the social influences on health for younger athletes—a subject that remains insufficiently explored, as noted by Dr. Kim.
By reviewing a vast collection of national and international data accumulated over the past three decades on SCA/D incidents in athletes, Kim and his team from Lausanne University Hospital, Morristown Medical, Massachusetts General Hospital, and other leading institutions evaluated the significant racial inequities that continue in the realm of athlete electrocardiography (ECG) screenings, which are now standard for competitive athletes.
These screenings often produce more false positives among Black athletes, indicating that these athletes may incorrectly receive a diagnosis of a serious heart condition. This issue is especially concerning for those who have limited access to thorough follow-up testing, leading to unnecessary anxiety and a lack of confirmation regarding the accuracy of their results.
Factors such as economic stability, access to healthcare facilities, availability of health information, and experiences of discrimination significantly affect health outcomes, even in young athletes. Dr. Kim suggests that incorporating social determinants of health into future studies could improve our understanding of how to alleviate these impacts on youth athletes.
“Addressing these disparities requires more than just screening for possible health issues,” says Kim. “We must understand and tackle the underlying social factors that elevate the risks for these athletes.”
In their review in the Lancet, Kim and his colleagues emphasize that effective management of sudden cardiac arrest among athletes begins with a thorough pre-participation evaluation (PPE), which needs to be well-structured and sufficiently resourced. “We ought to look for potential underlying health problems and be aware of the various environmental challenges that young individuals encounter in their upbringing,” explains Kim. A comprehensive PPE history and physical examination should ensure proper follow-up, particularly if ECGs are performed and any abnormalities are found.
This increased attention to the issue marks a significant change. “Five to ten years ago, I doubt many people were considering social determinants of health and their effects on young athletes,” remarks Kim. Asking these vital questions is a crucial step forward. Going ahead, it’s important to not only keep raising these questions but also to actively address them.
