February 4, 2011 Liz Borkowski, MPH 4Comment

Ben McGrath has an excellent article on “the NFL and the concussion crisis” in the January 31st issue of the New Yorker. It’s well worth a read (though it might change the way you see the Superbowl), but the thing I want to highlight is the roles of Alan Schwarz and the New York Times in raising the public’s awareness of a problem that pervades football. (For our international readers, I’m referring to the US version of football – I realize that word means something different in the rest of the world.)

Specifically, the problem is the effects of repeated brain trauma, which football players often experience during games and practice alike. McGrath gives a snapshot:

Chronic traumatic encephalopathy, or C.T.E., is the name for a condition that is believed to result from major collisions–or from the accumulation of subconcussions that are nowhere near as noticeable, including those incurred in practice. It was first diagnosed, in 2002, in the brain of the Pittsburgh Steelers Hall of Fame center Mike Webster, who died of a heart attack after living out of his truck for a time. It was next diagnosed in one of Webster’s old teammates on the Steelers’ offensive line, Terry Long, who killed himself by drinking antifreeze. Long overlapped, at the end of his career, with Justin Strzelczyk, who was also found to have C.T.E. after he crashed, fatally, into a tanker truck, while driving the wrong way down the New York Thruway.

Knowledge of this problem might have remained limited to the medical and football community if Chris Nowinski – “a Harvard football player turned pro wrestler turned concussion activist” – hadn’t convinced his freelance-writer friend Alan Schwarz to pitch the story to New York Times Sports editor Tom Jolly. Then, the Times made a few of crucial decisions.

McGrath explains that Jolly could’ve assigned the story to one of his staffers, but instead asked Schwarz, who’d been writing Sunday sports columns about statistical analysis. Nowinski told McGrath that writers who covered football hadn’t wanted to touch the story, because they didn’t want to lose their access to important sources. Schwarz, on the other hand, wrote about baseball and didn’t seem to care about upsetting the football establishment – whose reaction to Schwarz’s stories “was not warm.”

In early 2007, Schwarz wrote a series of articles that the Times ran on the front page:

Expert Ties Ex-Player’s Suicide to Brain Damage from Football,” 1/18/07
Dark Days Follow Hard-Hitting Career in N.F.L.,” 2/2/07
Wives United by Husbands’ Post-N.F.L. Trauma,” 3/14/07

Then came the next crucial decision by the Times. McGrath writes:

Glenn Kramon, an assistant managing editor at the Times who oversees long-term, Pulitzer-worthy projects, read this piece and decided to intervene. Schwarz was given a full-time position, with no responsibilities other than to broaden his new beat’s focus beyond the N.F.L. to the more than four million amateur athletes who play organized football. Although Schwarz was assigned to the sports desk, the Times framed the story as a matter of public health, akin to tobacco, asbestos, and automobile safety. Schwarz covered high schools, helmets, workmen’s comp, coaching, and so on, earning the nickname Alan Brockovich among friends.

McGrath explains that the articles threatened to diminish the pipeline of future football players, and one ESPN writer characterized the NFL’s feeling as “This guy’s out to get football.” The League’s response has evolved over the past few years, though; NFL medical adviser Dr. Joseph Maroon characterized their reaction to the problem of brain damage as shifting from active and passive resistance to passive acceptance and finally to active acceptance.

Although the NFL’s response might not be all that the public health community would hope for, they took a major step last July when they produced a locker-room poster stating that “concussions and conditions resulting from repeated brain injury can change your life and your family’s life forever.” In his article on the event, Schwarz called it “by far the N.F.L.’s most definitive statement on the cognitive risks of football.”

Everyone interested in football (as entertainment, a public-health issue, or both) should read McGrath’s article for more on how the NFL is addressing this challenge; the New York Times’ archive on football and concussions is also a great resource. The point I want to make here is that the NFL probably wouldn’t have been making these kinds of changes right now if it weren’t for Schwarz’s series of articles. McGrath’s piece makes it clear that in addition to Schwarz’s talent and dedication, vision and support from the New York Times’ Tom Jolly and Glenn Kramon were essential to the project.

How many newsrooms today have the resources to support this kind of reporting? A look at recent winners and finalists for the Pulitzer Prize in Public Service and Investigate Reporting shows that in-depth, top-notch reporting that benefits the public good still happens. As newspapers downsize, though, fewer journalists will have opportunities like the one Schwarz had at the New York Times. I’m glad to see nonprofit organizations like ProPublica – which won a 2010 Investigative Reporting Pulitzer for Sheri Fink’s work on life-and-death decisions made by doctors cut off by Hurricane Katrina floodwaters – developing a model of journalism that doesn’t rely on selling ads in print publications. As we decide what to read and whether to subscribe to different news outlets, we should remember that good journalism plays an important role in improving public health.

4 thoughts on “Football, Journalism, and Public Health

  1. While I don’t doubt the importance of these articles, I’m not sure about your statement How many newsrooms today have the resources to support this kind of reporting?

    There are other newsrooms cover these topics in places where you might expect they also don’t want to risk their access to the football establishment. For example see:
    http://sportsillustrated.cnn.com/vault/article/magazine/MAG1176377/1/index.htm
    which was part of a special issue on football head injuries. That article has some of the best lay science writing I’ve seen on the topic that accurately describes the science in a nuanced way, and explains how the issue isn’t just classic concussion. By it’s keeping the focus on high school students, it’s a real discussion of public health issues rather than about the issues of the relatively few people who make it to the top of the sport.

    It is both scary and prescriptive and well worth a read even if it’s not in the New Yorker and probably won’t win a Pulitzer PRize.

  2. I read the cover story in Sports Illustrated as well; they didn’t pull any punches.
    Also, before the concussion issue came to prominence, the magazine had run articles in recent years dealing with other damage players had suffered that, in some cases, seriously undermined the quality of life in their later years–guys who couldn’t walk, great quarterbacks like Johnny Unitas who lost full use of a hand, and, in one case, a guy who had a foot amputated.
    They’ve also run articles dealing with the issue of players overheating and dying during practice. SI visits the dark side of sports on a regular basis, and some of us, even sports fans, have been talking about this stuff for years.

  3. Thanks for the link, bsci – it’s another interesting article worth reading, and I agree that David Epstein does a great job describing the research in a way that’ll resonate with readers.

    One of the points McGrath makes about the importance of having Schwarz’s articles in the New York Times is that people who *weren’t* necessarily interested in football were reading them. He specifically mentions the “non-sports-fan mothers” of the “future sons of football” – with the implications that these mothers might steer their sons away from starting to play football in the first place if they were concerned about the game’s health risks and didn’t have any particular attachment to it. Whether or not Shwarz’s writing actually affected people in this way or in other ways that would harm the sport, the football industry seems to have felt particularly threatened by the long series of NYT articles. (Or at least, that’s the sense McGrath got from the people he interviewed.)

    I’d be interested to hear from football fans how the concussion issue has played out over the past few years as more information has come out about the effects of repeated head trauma. Is this something that gets discussed in online forums or brought up in conversations about recent games? Have fans been vocal about, say, dropping support for a particular team based on their handling of head injuries?

    I hope Sports Illustrated (and other sports media covering concussions) also continues to have the resources to put into this kind of reporting, because I suspect it isn’t the most profitable aspect of their business.

  4. This is such an interesting and sad issue. I first read about it in 2009 in the Sacramento News & Review in an article on a local ex-NFL player with chronic traumatic encephalopathy:

    http://www.newsreview.com/sacramento/content?oid=1317643

    I’m glad the NFL feels threatened and that journalists and advocates are not backing down. Things get dicey when a job overlaps with fame, entertainment, and machismo, but these are still people who are crippling and killing themselves to do their work.

    I can’t say much about football fans, but as a hockey fan I have a feeling that a team’s handling of injuries wouldn’t change fans’ opinions. Sports fandom is an odd beast, and not particularly logical! I think hockey fans have been accepting of changes made by the NHL to reduce concussions, like banning blindside hits to the head, but there is still a lot of progress to be made and I am not sure how fans would react to more sweeping changes.

    I think systematic changes from the organization level are most needed for preventing these kinds of injuries. I can see the importance of warning young athletes and parents about the dangers of the sport, but I don’t think trying to steer people away from playing is the answer. People love the game, they’re going to play, and the rules clearly need to be changed to protect players.

    If the NFL could step up and make the statement that brain injury is a huge health problem, their players’ lives are important, and they are going to start making changes to protect them – that would be a great start. They obviously aren’t willing to do this without pressure, hopefully the publicity generated by these articles will help push them in the right direction.

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