Risk Factors for Short and Long Term Adverse Health Outcomes among College and Professional American Football Players

November 9, 2018 @ 12:00 pm – 1:30 pm
Falk College, MacNaughton Hall, Room 411
150 Crouse Dr
Syracuse, NY 13244
Katie Gratien


Brittany Kmush, Public Health
Arthur Owora, Public Health
Shane Sanders, Sport Management
Bhavneet Walia, Public Health


Long-term adverse health outcomes, particularly those associated with concussions including chronic traumatic encephalopathy, depression, and mortality, are of growing concern among elite athletes, especially American football players. Here, we present a preliminary analysis of mortality rates among NFL players and the association of mortality with position. Data were collected from Pro Football Reference, a free online database maintained by Sports Reference LLC that includes playing statistics from every player in the NFL starting in 1922. Of the 24,860 players in the database, 6,603 (26.6%) had a reported date of death. Years of birth ranged from 1876-1996 and years of death from 1923-2018. The average life expectancy from birth was 79.5 years and the incidence rate of death was 3.94 per 1000 person-years (95% CI: 3.82-4.06). Consistent with previously published results, no differences in risk of death were observed by position category after adjustment for birth year, BMI, and height; increasing BMI and birth year were statistically associated with increased hazard of death (p<0.05). However, this analysis is plagued by the same confounders as previous research; dividing players into position categories does not capture the differing exposures to risk factors for concussions and other head trauma resulting from different styles and amounts of play. We are currently completing further analysis to examine mortality, incorporating cause of death, by on-field playing characteristics. We are completing a similar analysis of NCAA football players.

Literature on the etiologic risk factors of college football related injuries is limited; yet, college football accounts for the largest number of physician assessments in college athletics. The object of this study was to address some of the gaps in the literature by examining whether physiological and socio-behavioral factors differentially predict injury risk among college football players using data from the 2016/17 Syracuse Football team. Our preliminary results suggest the (1) lower age (or class) and to a less extent experiencing depression-related symptoms are correlated with heightened risk of injury and (2) defensive backs (ie: two cornerbacks and two safeties) are at highest risk of injury. These results point to the need for targeted injury prevention efforts among young (new recruits) college football players especially those in the defensive back positions.

Additional Information

Catered lunch served during presentation.