Pigskin Crossroads

A skilled epidemiologist joins forces with an up-and-coming investigative political scientist to write a unique and dynamic treatise on player concussions in the National Football League (NFL). Using concussion data from the NFL's website during the last three regular seasons (2010-2012), incidence and risk factors of concussions are calculated and compared for a range of factors rarely or never studied before. The eye-opening results help shed light on possible ways to prevent and reduce the rate of these head injuries and the long-term risks of cognitive decline.

The existing epidemiological literature on concussions in the NFL is sparse, mainly comprised of several articles written by NFL-affiliated researchers whose work has come under intense scrutiny and challenge by the scientific community and the U.S. Congress. "Pigskin Crossroads" fills some of the gaps related to this subject from an independent perspective. Concussion incidence rates are computed and analyzed for team, week of season, day of week, speed versus non-speed positions, conference, field surface, home versus away games, starters versus nonstarters, and other critical variables. Rates of concussions in games worked by replacement versus regular referees are compared. The risk of repeat concussions between regular seasons is also analyzed. An exposure-response analysis describes the link between the number of games played and the occurrence of concussions. Intriguingly, teams of concussed players are more likely to lose games, both overall and on the day that the concussions occur.

Rigorous statistical tests identify differences between the groups under study, and all methods are explained in a way that is accessible to a lay as well as professional audience. Key results are illustrated in stunning graphs and figures, and for those who enjoy data, there are 27 appendices that allow readers to get in the trenches of the results.

The backdrop for this empirical research is six critical essays on the politics surrounding the key issues in the NFL concussion crisis. This includes a comprehensive description of its history along with the making and remaking of league policies, protocols, and rules related to concussions, and the significant shift in NFL public relations. Another chapter discusses helmet safety standards, and the final essay details the massive ongoing class-action lawsuit against the NFL and helmet manufacturer Riddell involving nearly 6,000 retired players and families. The litigation has brought the situation to a critical juncture that may threaten the future of the game as we currently know and love it.