he Centers for Disease Control and Prevention is our nation’s premier public health agency. It’s also one of my most trusted sources of health information. I look to the CDC to get facts I can trust on everything from childhood vaccinations to safe drinking water. But I’ve become concerned about whether its information on sports-related concussions is fully independent from influence by the sports industry.
The CDC sometimes turns to outside organizations such as the National Cancer Institute or the Bill and Melinda Gates Foundation to help out with its research and education programs. These partnerships generally result in effective collaborations to advance the public’s health.
An undependable partner can cast a shadow over the CDC’s otherwise superb public health efforts. Based on a study I recently co-authored in the journal Injury Prevention with public health ethicist and lawyer Daniel Goldberg, I’ve concluded that the NFL is one such unreliable partner. In reviewing the NFL’s concussion-related research and education programs, our analysis found that the NFL’s private agenda isn’t compatible with public health objectives.
The NFL has made multiple efforts to team up with U.S. federal health agencies to address sports-related concussions. Most notably, its $30 million donation in 2012 to the National Institutes of Health for brain research received widespread media attention and was the subject of a congressional investigation. The NFL ultimately backed out of the arrangement.
By contrast, the NFL’s partnership with the CDC has received relatively little media coverage or scholarly attention. Even though I began studying the football safety debates in 2013, I did not come across any news stories or academic research that described the current partnership between the two organizations. As a consequence, I wasn’t aware of this partnership until stumbling across a sidebar on the CDC’s website explaining that the NFL, along with other major sports governing bodies, had teamed up with the CDC to produce educational materials on youth sports concussions.
Even more surprising to me was discovering that the CDC’s website also hosts a video featuring NFL Commissioner Roger Goodell. He spends much of the video promoting the NFL’s efforts to address brain trauma in sports. He discusses concussions in the context of a broad range of youth sports, without once mentioning that tackling is associated with particularly high risks of repetitive brain trauma.
Goodell further contends that NFL athletes “receive the most up-to-date medical information on all issues including concussions, and I believe they receive the best medical treatment in all of sports, and probably the world.” The video’s implication that the league prioritizes the health of its athletes will no doubt come as a surprise to former NFL players. The NFL has previously acknowledged that about 1 in 3 retired NFL players will go on to develop long-term cognitive problems at younger ages than the general population. The league also notoriously spent years denying the risks of brain trauma associated with tackle football, and has recently come under fire for promoting tackling programs based on questionable evidence.
As a public health researcher, I’ve learned to be skeptical when industries fund public health programs intended to address the very health problems associated with the products those industries sell. After all, how many Americans would trust the CEO of Philip Morris to provide them with the most accurate information on how to address the risks of cigarettes? In fact, this fall the World Health Organization issued a statement detailing why it would not partner with a foundation funded by Philip Morris. The WHO explained that the tobacco industry’s decades-long history of misconduct “means that research and advocacy funded by tobacco companies and their front groups cannot be accepted at face value.”
To examine whether the NFL influenced how the CDC’s materials framed the issue of sports-related brain trauma, Goldberg and I reviewed the educational concussion poster and fact sheets that the CDC had produced with support from the NFL as well as other national sports governing bodies. The CDC handouts focus on concussions, but they don’t mention that sub-concussive trauma can contribute to cumulative brain damage, even if player collisions don’t immediately cause symptoms. The fact sheets also ignore evidence that even the best player education or post-injury concussion management cannot prevent the inherent risks of repeated brain trauma associated with tackling. These omissions suggested that not only were the NFL and other league logos emblazoned on this CDC material, but the content of the fact sheets was influenced by the sports leagues’ perspectives.
Based on our research, it appears that the NFL is trying to gain credibility by working with respected public health agencies like the CDC and is using this work to promote its viewpoint that it is possible to prevent brain trauma in a full-body collision sport like football.
It’s getting harder and harder to trust the NFL with children’s brains. But Americans need to be able to trust the CDC to provide the highest-quality public health information without conflict of interest. In order to keep advancing the public’s health as their highest priority, public health agencies should call a “timeout” on partnerships with the NFL.
Kathleen E. Bachynski is a postdoctoral fellow at the Division of Medical Humanities at NYU Langone Health.