The drug, of course, is football. Which is why Lewis Margolis can’t help but ask: should anyone’s child play the sport?
“I’m not saying that everyone should be placed into bubbles,” he says. “But we have enough evidence now to know that there are harmful consequences from these traumatic brain injuries. We know that. And kids are exposed to this. To continue to allow children to participate [in football] in an unencumbered way, to me, is no different than exposing them to an untested medicine or medical device. Only it’s being done without the tools, procedures, and protections essential to medical research.”
A public health professor at the University of North Carolina, Margolis specializes in maternal and child health. His campus office is a 10-minute walk from Guskiewicz’s. His views on youth football might as well be from another planet. In an opinion article published on the website Inside Higher Ed, Margolis argued that allowing children to play tackle football is not only the equivalent of an uncontrolled, nationwide research project in concussion medicine and science, but also an unethical project that parallels the infamous Tuskegee Study—in which the U.S. Public Health Service monitored but did not treat a group of rural African Americans suffering from syphilis over a period of decades.
“That article raised the eyebrows of people around here,” Guskiewicz says. “The analogy is absurd and embarrassing.”
Guskiewicz has a point: likening football to venereal disease is pretty out there, even as a thought exercise. Margolis admits as much. He also notes that parents, coaches, school administrators, and concussion researchers all have the best interests of children at heart—unlike the Tuskegee scientists, who didn’t even tell their research subjects what was happening.
Still, Margolis maintains that the football-to-research comparison is apt. And he’s not alone. According to the book League of Denial: The NFL, Concussions, and the Battle for the Truth, the NFL once contracted with a bioengineering firm to help run a first-of-its-kind epidemiological study of concussions in professional football. A memo from the firm read as follows:
A major obstacle to head injury research is the unavailability of willing test subjects. The NFL has graciously sponsored a research program offering its players as those living subjects.
“Just because you’re doing something with goodwill doesn’t make it ethical,” Margolis says. “If Kevin [Guskiewicz’s] research or my research generates a risk, then we have to ask, ‘Is that risk acceptable?’ Is an 80 percent increased risk of brain damage acceptable? Fifty percent? Ten percent? If football generates a risk, then we have to ask the same question. This is a discussion for public health. Not just coaches.”
Public health focuses on preventing predictable problems. On stopping harm before it happens. Last year, the Consumer Product Safety Commission banned the sale of Buckyballs, small magnetic toys that can pinch intestines and require surgery when swallowed by children. Federal regulators enacted the ban following 22 swallowing cases over a three-year span. By contrast, youth football has produced far more than 22 concussions among children over the last three years. Seven high school football players have died this year, five from brain injuries and two from spine and neck injuries.
Yet society’s response—from the NFL to Pop Warner—has been akin to running a yellow traffic light. Look into the problem, be more aware, spend some money on research, change a few rules. But keep driving. Margolis thinks it should be more like stopping on red: figure out the risks of football in a controlled setting under established clinical standards, and then decide if children should participate.
This goes double for schools.
Schools, Margolis says, have two primary duties. Nurture young minds. And protect the children in their care. Hence, homework. Study halls. Anti-bullying campaigns. Not allowing drugs or guns on campus. Schools receive public funds—and are tax-exempt institutions—to help carry out these duties. No high school would start and sponsor an official mixed martial arts team. Not without provoking parent outrage.
What makes football—a known vector of student brain damage—so different?
“I’m not saying sports don’t belong on campuses,” he says. “But take UNC. How do they tolerate that they are knowingly sending kids out there [to play football] with some risk—and we can disagree on the level—when it’s not consistent with the mission of the institution?”
In medical research, children cannot legally agree to participate in studies. Their parents or guardians have to give permission—and even then, the consent has to be informed. Participants have to know what they’re getting into. How much do most families know about brain damage and football? How much can they know, given both scientific uncertainty about the sport’s risks and the football industry’s concerted, ongoing effort to downplay those risks, particularly to children?