Skip to main content
SpringerLink
Log in

Conclusions, Implications, and Discussion

  • Chapter
  • First Online:
Mortality and Its Risk Factors Among Professional Athletes

Part of the book series: SpringerBriefs in Public Health ((BRIEFSPUBLIC))

  • 324 Accesses

Abstract

Internal results indicate that African-American race is a consistent predictor of mortality risk. While race is immutable, improving income and education could impact favorably on African-American mortality risk. Surprisingly, no NBA players are categorized as obese. The validity of BMI cutoffs as a mortality predictor is challenged within NBA players. Southern birthplace raises mortality risk for NFL, but not NBA, players. Since players born in the South are over-represented in both the NBA and especially the NFL, changes are required to help reduce this risk. There’s no indication of exposure-response between mortality and playing in the NBA or NFL. Length of playing career and mortality risk are inversely related in the NBA, but not the NFL, possibly reflecting an SES effect associated with player earnings. No explanation can be given for the excess risk of mortality within NBA centers and follow-up research with additional variables, including cause of death, is required. The between-league mortality differences uncovered in this study are modest and suspicious. When BMI is dropped from analyses, the between-league effects disappear.

Much like previous research of elite athletes, external comparisons between NBA and NFL players versus the general population document reduced mortality rates among players. Analyses of worldwide mortality rates help explain why the bar may not be set very high when the US general population is used as a comparison group for elite, world-class NBA and NFL athletes. Despite some unknown prevalence of CTE, mortality rates within NFL players is still significantly lower than the general population. Study limitations are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ahima, R. S., & Lazar, M. A. (2013). The health risk of obesity—Better metrics imperative. Science, 341(6148), 856–858.

    Article  CAS  PubMed  Google Scholar 

  • Arrighi, H. M., & Hertz-Picciotto, I. (1994). The evolving concept of healthy worker survivor effect. Epidemiology, 5(2), 189–196.

    Article  CAS  PubMed  Google Scholar 

  • Aune, D., Sen, A., Prasad, M., Norat, T., Janszky, I., Tonstad, S., Romundstad, P., & Vatten, L. J. (2016). BMI and all cause mortality: Systematic review and non-linear dose-response meta-analysis of 230 cohort studies with 3.74 million deaths among 30.3 million participants. BMJ, 353, i2156.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baron, S. L., Hein, M. J., Lehman, E., & Gersic, C. M. (2012). Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. American Journal of Cardiology, 109, 889–896.

    Article  PubMed  Google Scholar 

  • Baron, S., & Rinsky, R. (1994). Health hazard evaluation report, National Football League players mortality study. Report No. HETA 88–085. Atlanta: Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Retrieved from http://www.cdc.gov/niosh/pdfs/nflfactsheet.pdf

  • Barrioa, J. R., Jr., Small, G. W., Wonga, K. P., Huanga, S. C., Liua, J., Merrill, D. A., Gizac, C. C., Fitzsimmons, R. P., Omalu, B., Bailes, J., & Kepe, V. (2015). In vivo characterization of chronic traumatic encephalopathy using [F-18]FDDNP PET brain imaging. Proceedings of the National Academy of Science in the United States of America (PNAS), 112(16), E2039–E2047.

    Article  Google Scholar 

  • Bengtsson, T., & Mineau, G. P. (2009). Early-life effects on socioeconomic performance and mortality later in life: A full life-course approach using contemporary and historical sources. Social Science & Medicine, 68(9), 1561–1564.

    Article  Google Scholar 

  • Bennett, D. (2009). This is why NFL players die young. Deadspin. Retrieved from http://deadspin.com/5347189/this-is-why-nfl-players-die-young

  • Brown, C. (2007). Former players dealing with lingering health issues. New York Times. Feb 1, 2007. Retrieved from http://www.nytimes.com/2007/02/01/sports/football/01disability.html

  • BU (Boston University) CTE Center. (2016). Case studies. Retrieved from http://www.bu.edu/cte/our-research/case-studies/

  • Cole, T. J. (2000). Secular trends in growth. The Proceedings of the Nutrition Society, 59, 317–324.

    Article  CAS  PubMed  Google Scholar 

  • Eisen, E. A., & Robins, J. M. (2006). Healthy worker effect. In Encyclopedia of enviornmetrics. Wiley. doi: 10.1002/9780470057339.vah007. Retreived at: http://onlinelibrary.wiley.com/doi/10.1002/9780470057339.vah007/abstract;jsessionid=81DFE224CB454B226B18CCE202A1C9A6.f04t04

  • Elo, I. T., & Preston, S. H. (1992). Effects of early-life conditions on adult mortality: A review. Pop Index, 58(2), 186–212.

    Article  CAS  Google Scholar 

  • Emerging Risk Factor Collaboration. (2012). Adult height and the risk of cause-specific death and vascular morbidity in 1 million people: Individual participant meta-analysis. Intl J Epi, 41, 1419–1433.

    Article  Google Scholar 

  • Flegal, K. M., Kit, B. K., Heather Orpana, H., & Graubard, B. I. (2013). Association of all-cause mortality with overweight and obesity using standard body mass index categories: A systematic review and meta-analysis. JAMA, 309(1), 71–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fogelholm, M., Kapiro, J., & Sarna, S. (1994). Healthy lifestyles of former Finnish world class athletes. Med Sci Sports Exer, 26(2), 224–229.

    Article  CAS  Google Scholar 

  • Gardner, R. C., & Yaffe, K. (2015). Epidemiology of mild traumatic brain injury and neurodegenerative disease. Molecular and Cellular Neurosciences, 66, 75–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Goodman, H. A. (2016). 70 percent of NFL players are black men. Huffpost. Retrieved from http://www.huffingtonpost.com/entry/70-of-nfl-players-are-black-men-colin-kaepernick_us_57c7b12be4b07addc4114047

  • Gray, P. (2013). $100m to know why NFLers die young? Psychology Today. Retrieved from https://www.psychologytoday.com/blog/freedom-learn/201302/100m-know-why-nflers-die-young-here-s-why-free

  • Harrison III, N. (2015). Health insurance redefined for former NFL players. LinkedIn. Retrieved from https://www.linkedin.com/pulse/health-insurance-redefined-former-nfl-players-nolan-harrison-iii-mba?trk=prof-post

  • Hayward, M. D., & Gorman, B. K. (2004). The long arm of childhood: The influence of early-life social conditions on men’s mortality. Demography, 41(1), 87–107.

    Article  PubMed  Google Scholar 

  • Holstein, J. A., Jones, R. S., & Koonce, G. E. (2015). Is there life after football? Surviving the NFL. New York and London: New York University Press.

    Google Scholar 

  • Independent Football Veterans. (2014). The NFL was right: Football players die young. Retrieved from http://www.footballvets.org/blog/2014/07/nfl-was-right-football-players-die-young/

  • Janssen, I., & Mark, A. E. (2007). Elevated body mass index and mortality risk in the elderly. Obesity Reviews, 8(1), 41–59.

    Article  CAS  PubMed  Google Scholar 

  • Kalist, D. E., & Peng, Y. (2007). Does education matter? Major League Baseball players and longevity. Death Studies, 31, 653–670.

    Article  PubMed  Google Scholar 

  • Lamonica, M. (2015). Life after football. Newsday, January 22, 2015. Retrieved from http://projects.newsday.com/football/life-football/

  • Lawler, T., Lawler, F., Gibson, J., & Murray, R. (2012). Does the African-American-white mortality gap persist after playing professional basketball? A 59-year historical cohort study. Annals of Epidemiology, 22, 406–412.

    Article  PubMed  Google Scholar 

  • Lehman, E. J., Hein, M. J., Baron, S. L., & Gersic, C. M. (2012). Neurodegenerative causes of death among retired National Football League players. Neurol, 79, 1970–1974.

    Article  Google Scholar 

  • Lemez, S., & Baker, J. (2015). Do elite athletes live longer? A systematic review of mortality and longevity in elite athletes. Sports Medicine Open, 1(16.) https://doi.org/10.1186/s40798-015-0024-x.

  • Liang, S., Lv, G., Chen, W., Jiang, J., & Wang, J. (2015). Height and kidney cancer risk: A meta-analysis of prospective studies. Journal of Cancer Research and Clinical Oncology, 141(10), 1799–1807.

    Article  CAS  PubMed  Google Scholar 

  • Liao, Y., McGee, D. L., Cao, G., & Cooper, R. S. (1996). Short stature and risk of mortality and cardiovascular disease: Negative findings from the NHANES I epidemiologic follow-up study. Journal of the American College of Cardiology, 27, 678–682.

    Article  CAS  PubMed  Google Scholar 

  • Link, B., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior, 36(extra issue), 80–94.

    Article  Google Scholar 

  • Matthew, D. B. (2015). Just medicine: A cure for racial inequality in American health care. New York/London: New York University Press.

    Google Scholar 

  • McGee, D. L., & Diverse Populations Collaboration. (2005). Body mass index and mortality: A meta-analysis based on person-level data from twenty-six observational studies. Annals of Epidemiology, 15(2), 87–97.

    Article  PubMed  Google Scholar 

  • Mez, J., Daneshvar, D. H., Kiernan, P. T., et al. (2017). Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. JAMA, 318(4), 360–370.

    PubMed  PubMed Central  Google Scholar 

  • Miech, R., Pampel, F., Kim, J., & Rogers, R. G. (2011). The enduring association between education and mortality: The role of widening and narrowing disparities. American Sociol Review, 76(6), 913–934.

    Article  Google Scholar 

  • Nevill, A. M., Winter, E. M., Ingham, S., Watts, A., Metsios, G. S., & Stewart, A. D. (2010). Adjusting athletes’ body mass index to better reflect adiposity in epidemiological research. Journal of Sports Sciences, 28(9), 1009–1016.

    Article  PubMed  Google Scholar 

  • NIOSH. (2012). Health concerns for NFL players. March, 2012. Retrieved from https://www.cdc.gov/niosh/pgms/worknotify/pdfs/NFL_Notification_01.pdf

  • Omalu, B. I., DeKosky, S. T., Minster, R. L., Kamboh, M. I., Hamilton, R. L., & Wecht, C. H. (2005). Chronic traumatic encephalopathy in a National Football League player. Neurosurgery, 57(1), 128–134.

    Article  PubMed  Google Scholar 

  • Panel on Race, Ethnicity and Health Later in Life. (2004). Understanding racial and ethnic differences in health in later life. National Research Council of the National Academies. Washington, D.C: The National Academies Press.

    Google Scholar 

  • Perez-Cornago A, Appleby PN, Pischon T, Tsilidis KK, Tjønneland A, Olsen A, et al. (2017). Tall height and obesity are associated with an increased risk of aggressive prostate cancer: Results from the EPIC cohort study. BMC Medicine 15:115.

    Google Scholar 

  • Roberts, D. (2012). Debating the cause of health disparities. Cambridge Quarterly of Healthcare Ethics, 21, 332–341.

    Article  PubMed  Google Scholar 

  • Samaras, T. T. (2012). How height is related to our health and longevity: A review. Nutrition and Health, 2(4), 247–261.

    Article  Google Scholar 

  • Satcher, D., Fryer, G. E., McCann, J., Troutman, A., Woolf, S. H., & Rust, G. (2005). What if we were equal? A comparison of black – White mortality gap in 1960 and 2000. Health Affairs, 24(2), 459–464.

    Article  PubMed  Google Scholar 

  • Schott Foundation for Public Education. (2015). Black lives matter: The Schott 50 state report on public education and black males. Retrieved from http://blackboysreport.org/bbreport2015.pdf

  • Sports Business News. (2016). 2016 National Basketball Association racial and gender report card. Retrieved from http://www.sportsbusinessnews.com/node/36737

  • Tall Life. (n.d.). Height percentile calculator, by age or country. Retrieved from https://tall.life/height-percentile-calculator-age-country/

  • Teramoto, M., & Bungum, T. J. (2010). Mortality and longevity of elite athletes. Journal of Science and Medicine in Sport, 13, 410–416.

    Article  PubMed  Google Scholar 

  • The Global BMI Mortality Collaboration. (2016). Body-mass index and all-cause mortality: Individual-participant-data meta-analysis of 239 prospective studies in four continents. The Lancet, 388(10046), 776–786.

    Article  Google Scholar 

  • United Nations Population Division. (2009). Department of Economic and Social Affairs. World Population Prospects, The 2008 Revision, Volume 1: Comprehensive tables. New York.

    Google Scholar 

  • University of Michigan. (2009). Institute for Social Research. National Football League Player Care Foundation Study of retired NFL players. Retrieved from http://ns.umich.edu/Releases/2009/Sep09/FinalReport.pdf

  • US Census Bureau, Statistical Abstract of the United States. (2012). Table 232. Mean earnings by highest degree earned: 2009. Washington DC: Bureau of Census.

    Google Scholar 

  • US National Research Council. (2011). Difference between life expectancy in the United States and other high income countries. In E. M. Crimmins, S. H. Preston, & B. Cohen (Eds.), Panel on understanding divergent trends in longevity in high-income countries. Washington D.C: National Academies Press (US). Retrieved from https://www.nap.edu/read/13089/chapter/3#8

  • Williams, D. (1999). Race, socioeconomic status and health: The added effects of racism and discrimination. Annals of the New York Academy of Sciences, 896, 173–188.

    Article  CAS  PubMed  Google Scholar 

  • World Health Organization (WHO) World Health Rankings. (2014). Retrieved from http://www.worldlifeexpectancy.com/cause-of-death/all-cancers/by-country/

Download references

Author information

Authors and Affiliations

  1. Health Data Analytics, Princeton Junction, New Jersey, USA

    Jeffrey S. Markowitz

Authors
  1. Jeffrey S. Markowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 The Author(s)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Markowitz, J.S. (2018). Conclusions, Implications, and Discussion. In: Mortality and Its Risk Factors Among Professional Athletes. SpringerBriefs in Public Health. Springer, Cham. https://doi.org/10.1007/978-3-319-77203-5_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77203-5_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77202-8

  • Online ISBN: 978-3-319-77203-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation