Football, Boxing and head injuries

stadium

Last year Tyler Cowen wrote a speculative piece about how football might go into long term decline due to head injuries. Then Ta-nehisi Coates, a lifelong football fanatic, started posting how he was losing his love of football as he learned more about brain trauma. This got me wondering. The right analogy here is probably boxing, which declined in no small part due to high profile athletes like Muhammad Ali developing brain troubles. Will football go the way of boxing? At first I thought it was going to happen, but after digging in a bit more am less sure.

First let’s look at the risk of concussions. The rate of concussions per 1000 exposures is a measure of the risk of brain damage. For football it’s .60, which means for every 1000 practices or games you have .6 chance of getting a concussion. Here’s some rates:

  • Football   0.60
  • Lacrosse 0.30
  • Soccer     0.17
  • Wrestling 0.17
  • Basketball 0.10
  • Baseball 0.06

As expected, football is the highest risk. I wasn’t surprised by lacrosse either. But soccer is really not that far behind. You are only 3.5x more likely to get a concussion in a football practice than a soccer practice. That’s a lot, but not as big as 6x difference for basketball, or the 10x difference for baseball.

Next let’s look at sport popularity. This gallup chart below is a bit too busy to read easily, but the point is clear enough. Baseball remains steadily popular but went into relative decline in the 1960s, likely due to the rise of television. And basketball has had it’s ups and downs, but remains roughly on par with baseball. Football on the other hand is more popular than ever.

headinjuries

In fact, demographically football is more popular among younger people than older. Which implies it’s popularity will continue to grow. And it continues to be twice as popular among high school boys than the next sport, which is track and field.

We these facts as background, let’s see if we can spin out a decline of football scenario along the lines of boxing. First I think we’d see a decline in participation at the high school level. No matter how popular any sport is right now, it can’t attract the next generation of young players if parents believe there’s a high risk of brain injury. And this decline will be in part as kids themselves see high profile deaths, like NFL hall of famer Junior Seau’s suicide last year. After Seau’s death his autopsy showed he had chronic traumatic encephalopathy (CTE) brain damage. The parallel of Seau to Muhammad Ali is clear enough.

A new twist here is the ability to test for CTE while someone is still alive. Prior to last year, that was impossible. But now there are some pilot studies showing brain imaging techniques can identify it in living people. This means kids could be tested at the high school or college level in a scientific manner, which in turn would make legal liability much harder to avoid if an athlete keeps playing even after developing CTE. It would also undoubtedly make people with this diagnosis more likely to quit the sport.

Another cultural data point relevant here is the long term decline of violence, as documented by Steven Pinker, which I wrote about in a previous post. If you add all this up, you could extrapolate a world where high school participation slowly declines. And that decline eventually ripples down over 30 or 40 years to make football decline in general.

So how likely is this scenario for football to decline as boxing did? It’s impossible to know. But even though the sport is still gaining in popularity now, I think a 3.5x rate higher than soccer (and likely worse once detection for CTE gets better), along with larger societal intolerance of violence will in fact undercut football at the high school level. Eventually hollowing out support. But this will take a long time to play out either way. We’ll see.

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