The Korey Stringer Institute has updated its state-by-state sport safety policy rankings, and New Jersey has reason to pat itself on the back. 

New Jersey was the top-ranked state for its adherence to best practices developed for the top causes of sudden death in high school sports. Specifically, KSI bases its findings on each state’s adherence to policies set forth in the “Inter-Association Task Force Document Preventing Sudden Death in Secondary School Athletics.” 

According to the KSI website, the institute applies a rubric in which each state is assessed based on five equally weighted categories pertaining to sudden cardiac arrest, traumatic head injuries, exertional heat stroke, appropriate medical coverage, and emergency preparedness.

New Jersey, with a score of 79.03 out of 100, was followed by North Carolina (78.75), Massachusetts (71.4) and Kentucky (71.13). Colorado finished last out of all 50 states with a score of 23 for the second straight year. The overall median state score has improved over last year, coming in at 48.9. Full rankings can be found here.

KMI's rankings debuted in August 2017. At that time, North Carolina had the most comprehensive health and safety polices in place for secondary school athletics, with a score of 78.75. Colorado had the fewest, with a score of 23. The median state score was 47.1. States scoring in the top 10 percent were North Carolina, Kentucky, Massachusetts, New Jersey and South Dakota. States scoring in the bottom 10 percent were Minnesota, Montana, Iowa, California and Colorado.

According to KSI, more than 7.8 million secondary school athletes participate annually in a wide variety of sanctioned sports. From 1982 to 2015, there have been 735 fatalities (185 from direct causes, 550 from indirect causes) among high school student-athletes. During that time, there have also been 626 catastrophic injuries (613 from direct causes, 13 from indirect causes). Direct causes are attributed to trauma (e.g. athlete-to-athlete or athlete-to-object contact). Indirect causes are exertion based (e.g. exertional heat stroke, sudden cardiac arrest, asthma).

Andy Berg is Executive Editor of Athletic Business.