Abstract
Concerned about potentially increased risk of neurodegenerative disease, several health professionals and policy makers have proposed limiting or banning youth participation in American-style tackle football. Given the large affected population (over 1 million boys play high school football annually), careful estimation of the long-term health effects of playing football is necessary for developing effective public health policy. Unfortunately, existing attempts to estimate these effects tend not to generalize to current participants because they either studied a much older cohort or, more seriously, failed to account for potential confounding. We leverage data from a nationally representative cohort of American men who were in grades 7–12 in the 1994–95 school year to estimate the effect of playing football in adolescent on depression in early adulthood. We control for several potential confounders related to subjects’ health, behavior, educational experience, family background, and family health history through matching and regression adjustment. We found no evidence of even a small harmful effect of football participation on scores on a version of the Center for Epidemiological Studies Depression scale (CES-D) nor did we find evidence of adverse associations with several secondary outcomes including anxiety disorder diagnosis or alcohol dependence in early adulthood. For men who were in grades 7–12 in the 1994–95 school year, participating or intending to participate in school football does not appear to be a major risk factor for early adulthood depression.
Highlights
There has been growing concern about the long-term health consequences of playing American-style tackle football, driven in large part by high-profile suicides and case reports of chronic traumatic encephalopathy (CTE) among former players [1], increased risks or neurodegenerative disease [2], and associations between concussion history and cognitive impairment and depression later in life [3,4,5]
Our study suggests potential adverse effects of youth football participation might not manifest in early adulthood
We did not find evidence that participation in middle or high school football had a harmful effect on depression in early adulthood among a nationally representative sample of American men who were in grades 7–12 in the 1994–95 school year
Summary
There has been growing concern about the long-term health consequences of playing American-style tackle football, driven in large part by high-profile suicides and case reports of chronic traumatic encephalopathy (CTE) among former players [1], increased risks or neurodegenerative disease [2], and associations between concussion history and cognitive impairment and depression later in life [3,4,5]. This motivates us to study the following questions: to what extent, if any, do these benefits of sports participation extend to football players? And do the potential harms associated with repetitive head trauma associated with football participation outweigh these potential benefits?
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