Texas ranks in the top 25 in the country when it comes to preventing high school athletes from dying on the field. That's according to a study conducted by the University of Connecticut's Korey Stringer Institute,

which ranked all 50 states and the District of Columbia based on how well they've implemented policies and procedures to curb student-athlete deaths.

More than 7.8 million American high schoolers play sports every year. As those students return to school nationwide after a long summer, many — particularly football players — are bracing for sizzling, scorching and unsafe temperatures of 90 and 100 degrees.

The Stringer Institute, named after an NFL player who died of heatstroke after a Minnesota Vikings practice, estimates there were 222 high school sports-related deaths over the last decade from the heat or otherwise. Furthermore, a 2006 study on sudden death in young competitive athletes found there are about 110 deaths every year in the U.S. — roughly one death every three days. The conversation has been thrust back into the spotlight following the June death of 19-year-old University of Maryland freshman Jordan McNair, who collapsed while running sprints and died two weeks later of heatstroke. His body temperature at the hospital reached 106 degrees.

When it comes to high school sports, some states are significantly better at preventing deaths than others, but all of them have room for improvement. Texas ranks No. 21 in the country at preventing such deaths, according to the Stringer Institute, which updated its rankings this month.

The researchers created a rubric to assess how individual states ranked in preventing such deaths. It consists of five equally weighted sections: sudden cardiac arrest, exertional heat stroke, traumatic head injuries, appropriate health care coverage and emergency preparedness.

The institute doled out scores from as low as 23 percent to as high as 79 percent. Texas earned a score of 50.80 percent.

Texas scores among the nation's leaders in the emergency preparedness and sudden cardiac arrest
categories, the study found. Texas has room to improve in the traumatic head injury,
appropriate healthcare coverage, and exertional heat stroke categories.

Here are the best 10 states and their score:

  1. New Jersey, 79.03

  2. North Carolina, 78.75

  3. Massachusetts, 71.4

  4. Kentucky, 71.13

  5. Florida, 62.45

  6. Missouri, 62

  7. South Dakota, 60.58

  8. Washington, 60

  9. Wisconsin, 59.13

  10. Hawaii, 59.13

While those scores may not inspire much confidence, they're certainly better than the lowest scores. Colorado, California, Montana, New Hampshire and Wyoming rounded out the bottom five, with scores ranging from 23 percent to 37 percent. Samantha Scarneo, vice president for sport safety at the Stringer Institute, told TIME that these states should look to New Jersey as a model for what they should do. Over the past year, the state adopted new rules to require cold water immersion tubs, detailed instructions for returning to play and strength and conditioning limits.

"They're not sitting back and waiting for a kid to die to make these changes," Scarneo said.

There are four main causes of sudden death among athletes, the researchers said, and they account for 90 percent of sport-related deaths. The easiest way to remember them is with the four Hs: head, heart, heat and hemoglobin.

Head refers to traumatic head injuries, heart to to sudden cardiac arrest and heat means exertional heat stroke. Hemoglobin refers to exertional sickling, a unique condition where individuals with the sickle cell trait can have their red blood cells form into a sickle shape, causing them to build up and lose blood flow.

One question on the grading rubric asks whether automated external defibrillator are either at or within a few minutes of each sports venue. Another asks whether students are given enough time to acclimate to the heat. This includes limiting the number of daily practices over the first five days and the amount of total practice time on those days.

In the health coverage section, half of the total score is derived from one question: whether an athletic trainer — a health care professional — is required to be at all practices and competitions where collisions and physical contact is is involved.

Stringer institute CEO Doug Casa told the Hartford Courant teams should take preventative measures, such as ensuring players stay hydrated and avoiding practicing in extreme temperatures. He also suggested installing cold water immersion tubs.
"To me, that is very scary if you are a parent of an athlete doing two-a-day football practices in 90-degree temperature," Casa told the newspaper. "Parents need to be aware of that. I think sometime people think these things are in place. We don't have that policy of being top-down from the state level."

This article comes to us from our news partner Patch.com.