The discussion surrounding head trauma and the sport of football began more than 20 years ago. Fourteen years ago, the first case of brain disease was reported in a former NFL player, kicking off the “concussion crisis” that the NFL and football players, coaches and organizations across the country are still dealing with today.
The issue of head trauma in football is a thorny one. Complex, multifaceted and complicated by competing interests and incomplete information. But that doesn’t mean we should shy away from talking about it.
Three days before Super Bowl LIII, on Jan. 31, 2019, the Center for Sports Communication & Media at the University of Texas hosted its annual McGarr Symposium on Sports and Society. The topic for 2019: head trauma and the future of football.
“There is no simple solution,” CSCM director Michael Butterworth said in his introduction to the event. “The medical evidence cannot be ignored, yet even if an outright ban on tackle football were feasible, it’s not clear it’s desirable. In short, we are in need of not just a conversation about head trauma and the future of football, but also a vocabulary for how to have that conversation.”
The symposium featured 11 panelists and three separate sessions with Butterworth and former NBA player Lance Blanks, whose father played in the NFL, serving as co-hosts and guiding the conversation.
The symposium stretched over four hours, and it would be futile to try to summarize everything that was said, so instead, I’ll leave you with the three points that have continued to resonate with me more almost two weeks after the symposium.
When the issue of head trauma in football comes up in conversation, it often feels like everyone is over talking about it. They’re exhausted from defending their beloved sport or they’re tired of hearing the stories of heartbreak and struggle and deception when they feel powerless to create any type of change.
But after hearing from the journalists, medical experts and former players on the panel at the McGarr Symposium, I’ve been able to bring up this discussion with friends and acquaintances and add something new to the conversation. I hope that by relaying these few details from the symposium, you too will feel shaken out of complancenty and discover a new willingness to engage.
1. The demographics of football are changing.
Panelist Patrick Hruby recently wrote a piece for The Guardian about the nationwide decline in the number of high school boys playing football. The first takeaway to note is that although the numbers are shrinking (falling from 1.14 million high school footballers in 2008 to 1.07 million in 2017), football still remains by far the most popular high school sport in the country.
Something else Hruby noted, which was also covered in the January episode of HBO’s Real Sports with Bryant Gumbel, is that while overall participation numbers are down, an increasing number of poor kids are picking up the game.
According to research conducted by the Real Sports team, the proportion of high school football rosters in the state of Illinois (often considered a bellwether of the country at large) that is made up of boys whose families qualify for government assistance has risen nearly 25 percent over the last five years.
Upper- and middle-class parents, who often have more education and access to better information, are discouraging, or straight-out forbidding, their children from playing football. Boys of poor families, either because of a lack of information or a willingness to take on the inherent risks in pursuit of a college scholarship or NFL career, are still drawn to the game.
“To me, ethically, morally, if I were a football fan, I’d feel a little dicey about that,” Hruby said. “The ‘gladiator’ word was thrown around earlier today. That starts to feel a little gladiator-ish. It’s definitely adjacent. I mean, do we really want to have a bunch of rich people who are not risking anything sitting around essentially cheering for poor people to risk their health and well-being for their amusement? Is that really an appetizing thing to be doing at our high schools? I’m not sure, but that’s the kind of question that if this trend continues, I think you’ll actually see people start to ask.”
Another couple of percentages worth contemplating, while we’re at it: 6.5 percent of high school football players go on to the NCAA; 1.6 percent of college football seniors are drafted in the NFL. Meaning just 0.1 percent of high school football players make it to the NFL.
The chances of making it big don’t seem great enough for the risks involved.
2. Football’s concussion crisis is a public health issue.
Panelist Kathleen Bachynski studies tackle football safety at NYU Langone Health. Director Butterworth kicked off the third panel by asking her to clarifying what we mean by “public health.”
“The way I often tend to define public health is to contrast it with medicine or clinical expertise. So doctors, as we heard in the previous panel, tend to look at individual patients. What was this individual’s medical history? What personalized, individualized treatment might we give this individual. In public health, instead of looking at the health of individuals, we look at the health of populations. So it’s a sort of step back, of what is the broad health issue in this community and how do we address it?”
Bachynski went on to tally up the number of people who play organized football in this country every year. There’s about 2 million middle-school or elementary-school aged children playing in youth leagues, a little over 1 million teenagers on high school teams and thousands of athletes who compete at the college and professional level. Because there are more than 3 million people playing football in the United States in any given year, and each one of those individuals is exposed to whatever the risks of football are, head trauma in football can be considered a public health issue.
And if that’s the case, it opens up the possibility of regulating football like other public health risks have been in the past. Think smoking, drinking or wearing your seatbelt. You can’t smoke or drink until a certain age and everyone is required to wear a seatbelt while traveling in a car.
“At what point does something become so risky, that even a fully informed parent can’t allow their child to do it?” Bachynski said. “So even a parent that’s read all the lung cancer and smoking studies cannot give their child a cigarette. We’ve sort of decided as a society, you can’t do that … I don’t think we currently think of most sports in that way, but I do think a possible future of thinking about youth football might include sort of at what point can even a fully informed parent not expose their child to more than X number of hits to the head and more than X number of collisions in this sport.”
As Hruby pointed out, our perception as a society of what is risky and what is worth prohibiting or regulating takes a long time to change. When the law requiring drivers and passengers to wear seatbelt was first passed in 1983, many individuals rebelled, refusing to let the government tell them what to do. In 2017, the Washington Post reported that 85.9 percent of Americans regularly wear their seatbelts.
Perhaps an age requirement or all-out ban on youth football will eventually become the new normal.
3. The biggest threat to football, and the NFL, might not be what you think.
Sure, participation numbers are falling. But at their current rate of decline, it would likely be decades before a lack of high school participation really started to hurt the NFL’s bottom line.
But something that could really lead to the end of the sport of football as we know it is the insurance market.
Paneliest Dan Grano, a professor in the Department of Communications at the University of North Carolina at Charlotte, brought up this possibility, citing a recent investigation by ESPN’s Outside the Lines.
Prior to the deluge of concussion-related lawsuits the NFL has faced since 2011, more than a dozen insurance carriers made up the insurance market for pro football. Today, according to Outside the Lines, the NFL no longer has general liability insurance covering head trauma and only one company is willing to provide the league with workers’ compensation coverage.
As detailed by the Outside the Lines investigation, the evaporating insurance market and rising costs have already claimed their first victims. Maricopa County Community Colleges in Arizona eliminated football at four schools after determining that the teams accounted for a third of all insurance costs for the district. The North of the River Recreation and Park District in Bakersfield, California, cited a combination of rising insurance costs and declining participation in its decision to terminate its tackle football program in 2018.
Pop Warner Little Scholars recently switched insurers after its carrier refused to provide coverage without an exclusion for neurological injuries. In Hawkins County, Tennessee, the insurer for the local recreation department refused to cover football. Instead of cutting the sport, the department found a new carrier, which charges 27 percent more for coverage.
It’s not sexy. It’s not headline-grabbing. But when many cite money (as in how much money the NFL and NCAA are making off of football) as the reason this sport is untouchable, rising insurance costs could pose a very real threat.