Sports Medicine Research: In the Lab & In the Field: Are Football Related Concussions Causing a Behavioral Shift Away From Participation? (Sports Med Res)


Monday, April 9, 2018

Are Football Related Concussions Causing a Behavioral Shift Away From Participation?

Traumatic brain injury news reports and participation in high school tackle-football

Feudtner C, Miles SH. JAMA Pediatr. 2018. [Epub Ahead of Print].

Take Home Message: A recent decline in high school football participation coincides with an increase in news reports on football and brain injuries.

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The recent decline in adolescent boys participating in American football may be influenced by media coverage of football-associated health risks (concussions, chronic traumatic encephalopathy). However, there is little data available to support this notion. Therefore, the authors looked at football participation and news coverage of football-related concussions from 2001 to 2016. The authors extracted football participation numbers from the National Federation of State High School Associations and news reports about traumatic brain injury and football from the LexisNexis Academic public database. The authors found that from 2002-2008 there was a 9% increase in high school football participation; however, from that point to 2016 there had been a ~5% decline in participation.  Additionally, the authors reported that the number of news reports about football and brain injury was steady from 2001 to 2008, and then there was a marked increase in reports from 2009 to 2016. In contrast to football, the overall participation in high school athletics for adolescent boys is still increasing.

This study was interesting because the authors noticed that the timing of the shift from growth of high school football to a decline coincided with an increase in the number of news reports regarding American football and brain injury. While news coverage may be related to the decline in football participation it had little impact on other sports, in which participation rates continue to rise. We must use caution with these findings because a correlation between increased news coverage and a decline in football participation does not suggest that the news reports are causing the decline. There may be other factors leading to this behavioral shift such as a growing cost to athletes to participate in football or choosing to participate in other popular sports such as lacrosse or soccer. It would be fascinating to distinguish if this decline in participation led to a decline in high school concussion rates. It would also be interesting to follow up with high school students to determine if his/her decision to not participate in football was due to concerns about head injuries. Future research should further investigate the factors that are driving this behavioral shift away from football participation. Recreational sports, including football, are valuable strategies to promote physical activity. Hence, it is important for us to understand the decline in high school football and its implications (e.g., are athletes abandoning sports or switching to noncontact sports?). We also need to better understand how the media portrays brain injuries in football and help educate parents, athletes, and coaches when misinformation is provided. Currently, medical professionals should continue to educate athletes on the risks and mechanisms of a concussion, and ensure they understand that concussions can be sustained in many sports, not just football.

Questions for Discussion: Do you see a decline in high school football? Do you believe athletes that do not choose to play football are still participating in other contact sports?

Written by: Jane McDevitt
Reviewed by: Jeffrey Driban

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