Public Health

Whither Football?

September 17, 2014

Accumulating health evidence about football

football picLast Saturday night, when we met my father for our regular dinner, I said to him, “So, did you read the New York Times article on football this morning? The evidence about the harms of football for players is now incontrovertible, as the recent settlement with the NFL shows. Maybe football is at the end of the line.” First, he told me that no one is going to end football on the basis of the evidence. Then Pro football may be an issue, he said, but college football isn’t really a problem. Then he talked about the terrible game his Michigan Wolverines had played earlier that day.

My father is a smart man, and he’s not a sports fanatic. He understands something about risk, having spent years working to dissuade people from smoking cigarettes. For him and millions of other Americans, football is as much a harbinger of autumn as are falling leaves. Yet, as a person who spends a fair amount of time focused on public health evidence, I can no longer ignore the impressive body of cumulative evidence showing that football is a formidable health threat to players, with short-term and long-term harm to many players’ brains. Of course, not every football player will experience harm, but the rates of brain injury for players are far above the norm. That said, I understand and respect that my university and most others will continue to celebrate football and enjoy the game.

Durham Herald-Sun editor Bob Ashley wrote last Sunday that we should take a serious look at the game so many love. In “Tackling the troubled future of our beloved football,” he wrote, “The ancient Romans worried about bread and circus as gladiators fought to the death in the arena. It did not turn out well. Is there a lesson for us here?”

Below are excerpts from PBS and The New Yorker, with more detailed data on the health consequences of football.

From PBS: July 7, 2014. League of Denial: The NFL’s Concussion Crisis. “Judge Approves NFL Concussion Settlement” by Jason M. Breslow

Judge Brody’s decision comes just 10 days after the NFL agreed to remove a cap on any damages it will pay as part of the settlement. In January, [Brody] rejected an original settlement of $765 million, saying she did not believe that the $675 million set aside for damages would be enough to compensate every player who might one day require aid.

The agreement allows for payments as high as $5 million for league veterans diagnosed with Lou Gehrig’s disease; as much as $4 million for a death involving traumatic brain injury; and as much as $3 million for players suffering from dementia. It includes $75 million for baseline medical exams for retired players and $10 million for concussion research and education, but it does not require the NFL to admit that it hid any information from players about the dangers of repeated hits to the head.

“This is an extraordinary settlement for retired NFL players and their families — from those who suffer with neurocognitive illnesses today, to those who are currently healthy but fear they may develop symptoms decades into the future,” plaintiffs’ attorneys Sol Weiss and Christopher Seeger said in a statement.

From The New Yorker: October 19, 2014, “Offensive Play” by Malcom Gladwell

This is a crucial point. Much of the attention in the football world, in the past few years, has been on concussions—on diagnosing, managing and preventing them — and on figuring out how many concussions a player can have before he should call it quits. But a football player’s real issue isn’t simply with repetitive concussive trauma. It is, as the concussion specialist Robert Cantu argues, with repetitive subconcussive trauma. It’s not just the handful of big hits that matter. It’s lots of little hits, too.

The article documents the fact that much of the brain damage occurs through the combination of hits from practice and hits from games. Some of the data are from UNC-Chapel Hill professor Kevin Guskiewicz’s seminal research in this area.


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The views expressed in this blog are Barbara Rimer’s alone and do not represent the views and policies of The University of North Carolina or the Gillings School.