The following piece appeared in the Houston Chronicle on February 1, 2017.
More than 100 million viewers will tune in to Super Bowl LI at NRG Stadium in Houston this Sunday, and I’ll be one of them. Football’s premier game is a spectacle of fun, competition, and community spirit. Yet year after year, as I enjoy the game, I find it hard to forget the injuries and concussions that football leaves in its wake, and the dangerous example it sets for young children.
More than three million U.S. youth ages six to 17 played tackle football in 2015. And every year, more than 25,000 football players between ages eight and 19 land in the emergency department with head injuries. Still, football is the most popular high school sport, and Texas leads the nation in number of players: 165,359 student athletes played football in Texas in 2012-13.
Beyond the physical injuries from football, the game can inspire an attitude of recklessness, where winning is all that matters. We’ve all seen the injured player who, still physically able to play, shrugs off a headache with an expression like, ‘My bell was rung’—then does the “manly” thing and gets back on the field. When we watch this, as children, we learn that the definition of heroism and manliness is to tackle hard and brush off injury.
The National Football League (NFL) itself has estimated that 28% of its players will develop serious brain conditions – double the rate of the general population – and that these injuries will manifest earlier in life than usual. These outcomes also disproportionately impact Black men, who make up 70% of NFL players. Eighty-seven out of 91 deceased former NFL players (96%) have tested positive for chronic traumatic encephalopathy (CTE), a degenerative brain disease associated with memory loss, dementia, depression, and a likely heightened risk of suicide.
Unfortunately, tackle football just doesn’t work. Tackling inevitably means there will be head-to-head contact, in addition to other injuries. As a lover of football, I wish there were an easier solution than to ban it, but the fact is that tackling creates too great a toll on America’s youth. It’s one thing for professional athletes to take the risk for millions of dollars; it’s quite another to set a norm for a whole generation that the manly, fun thing to do is to disregard commonsense health protection. And though opportunities to become professional players are scant in reality, for many young players with few other options, football is seen as a gateway to college or to lifting one’s family out of poverty, despite the risks.
The NFL has made limited attempts to make the sport safer, such as setting harsher penalties for high-risk moves like head-butting and taking players with potential concussions off the field. But these rules simply don’t go far enough, and the NFL’s power to shape the way football is played at all levels demands that the League go further to protect players.
Pop Warner Little Scholars, a national nonprofit that organizes football activities for kids age five to 15, has instituted rules to make football safer in recent years. Contact is limited during practices, and all practices must be attended by a person certified in CPR and First Aid, or who has a National Center for Sports Safety PREPARE Certificate of Completion. These are positive steps, but they become less effective when paired with a message that Pop Warner is preparation for “real” football— which starts in high school and becomes reckless. Among high school sports, football overwhelmingly accounted for the majority of catastrophic injuries between 1982 and 2013. And boys who participate in high school football are more susceptible to developing traumatic brain injuries, symptoms of which can surface years after the concussions occur.
Good news emerged this week from USA Football, the national governing body for amateur football, which said it will institute a pilot program this year with new rules to improve safety. The rules will include reducing the number of players on the field, eliminating kickoffs and punts, having smaller fields, and starting play in a crouch instead of a three-point stance. The changes, which will bring the game closer to flag football, came in response to parental safety concerns, USA officials said. If the pilot, set for a small number of teams and leagues, is successful, the rules will be rolled out nationally over the next few years.
These are encouraging steps toward changing the circumstances in which injuries occur — including how the sport is played and the risk-taking norms this style of play promotes. Other steps that would make high school and college football safer would be to require that certified trainers are present at every game, and to ban tackle football for children under age 15.
It’s time to stop saying that injuries are “accidents,” when we know football-related head injuries are both predictable and preventable. Health professionals need to speak up, again and again. Parents, football players, the NFL, universities, and fans—we all have a responsibility. When life-threatening and life-altering injuries are built into the way the game is played, it’s time to change the rules of the game.