Concussions & Youth Sports | Michael Lengefeld

youth football concussion

What is this research about?

Scientific knowledge of head injury resulting from sport dates to the 1800s. Between 2007 and 2014, all U.S. states passed concussion legislation regulating youth sports participation. Why were some U.S. states slower than others to pass concussion laws with return to play restrictions?

What did the researcher do?

The researchers located and analyzed data from 50 U.S. states on concussion laws and high school sports participation rates. Discourse around concussions has focused on youth athletes as a population at risk, which require risk-reduction medical policies to protect them. The amount of youth sport participation in a state identifies a key group of at-risk individuals. If a disease only affects a few individuals, it is less likely that medically informed laws will be passed. The concussion issue was framed by the NFL and others in terms of youth safety across all activities.

The constituency hypothesis: States with higher levels of youth sport participation will adopt concussion legislation earlier.

Alternatively, youth sport involvement could delay the adoption of concussion laws. Powerful social organizations and actors influence culturally significant activities. Cultural norms regarding youth sport have undermined the push for greater attention to head injuries. Interwoven themes of masculinity, violence and being "headstrong" have a long history in the NFL, and these same themes resonate in American football culture at all levels of competition. Consider the perspective of Chicago Bears wide receiver Brandon Marshall when commenting on the Miami Dolphins "bullying" scandal.¹

The resistance hypothesis: States with higher levels of youth sport participation will adopt concussion legislation later.

Source: YMCA of North Carolina — Youth athletes are especially susceptible to concussions
Source: YMCA of North Carolina

CDC Infographic — Center for Disease Control Infographic

NFL Wide Receiver Brandon Marshall — "Take a little boy and a little girl. A little boy falls down and the first thing we say as parents is ‘Get up, shake it off. You’ll be OK. Don’t cry.’ A little girl falls down, what do we say? ‘It’s going to be OK.’ We validate their feelings. So right there from that moment, we’re teaching our men to mask their feelings, to not show their emotions. And it’s that times 100 with football players. You can’t show that you’re hurt, can’t show any pain. So for a guy to come into the locker room and he shows a little vulnerability, that’s a problem. That’s what I mean by the culture of the NFL. And that’s what we have to change. So what’s going on in Miami goes on in every locker room."

youth football — Image Source: Stuart Seeger / Flickr, Creative Commons, https://flic.kr/p/pPWtH

What did the researchers find?

Institutional medicalization (the passage of medically informed legislation) varies with time and place.

Social context helps determine why states pass medically informed legislation at different times.

States with more high school football participation passed concussion laws later.

States with a strong college football presence (SEC Conference membership) passed concussion laws later.

States with more gender egalitarian views passed concussion laws earlier.

How can you use this research?

Policy makers can use this research to help craft public health strategies that incorporate understanding of unique social and cultural dynamics influencing the passage of public health law at the state level. Understanding these unique processes can help legislators formulate more comprehensive strategies to address public health crises. Public health organizations can use this research to inform their strategies for targeting public health problems in regions with greater resistance to these changes.

Citation

Rotolo T, Lengefeld M. 2020. "Clearing the cobwebs: An analysis of the timing of youth concussion legislation in U.S. states." Soc Sci Med. Nov 2:113491. doi: 10.1016/j.socscimed.2020.113491. PMID: 33162197.

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