Damar Hamlin’s collapse due to cardiac arrest during a nationally televised “Monday Night Football” game in early January shocked the country. The 24-year-old Buffalo Bills safety’s critical condition spurred widespread grief, followed by relief as he regained consciousness, communicated with his family and teammates, and was released from hospital care on January 11. Experts speculated that his incident might have been caused by commotio cordis, a rare condition where a blunt-force impact disrupts heart rhythm, drawing attention to the dangers of professional football and reigniting debates about the sport’s risks, especially at the youth level.
Football safety has been a long-standing concern, particularly regarding head injuries. High school participation in 11-player tackle football rose steadily through the early 2000s, but from 2009 onward, participation began to decline. This coincided with increased attention to concussion-related injuries and their long-term effects, such as chronic traumatic encephalopathy (CTE), highlighted in congressional hearings and rule changes in the NFL. The 2021-22 school year marked a milestone, as participation in high school 11-player football fell below one million for the first time in decades, showing a 12.2% decrease from the peak in 2008-09.
Football remains popular in certain parts of the U.S., particularly in the South and Midwest, with Mississippi, Alabama, and Texas having the highest participation rates. In contrast, states on the coasts, like New York, show significantly lower rates. Despite the overall decline in 11-player football, participation in smaller teams of six, eight, or nine players has risen, as more schools and players shift to these alternatives. However, youth football participation overall has dropped more steeply, especially among children ages 6-12, where tackle football participation declined nearly 18% from 2020 to 2021, while flag football participation rose.
Head injuries, particularly concussions, have been a major source of concern at both the professional and youth levels. Studies have shown a significant incidence of concussions among young football players, and long-term brain degeneration linked to repeated head trauma, such as CTE, has been found in the majority of former NFL players. These health risks contribute to the growing apprehension about the sport, influencing declining participation rates. Additionally, in recent years, high school sports overall have seen a decline in participation, with a 4% decrease in 2021-22, a trend likely exacerbated by the ongoing impact of the COVID-19 pandemic.
While school-based sports have seen a decline, other athletic avenues, such as club teams, remain a popular choice for many students. These alternative programs offer high-level competition and benefits like travel, though concerns about the health risks of football, both at the professional and youth levels, persist. The government’s Healthy People 2030 initiative recognizes the importance of physical activity for cardiovascular health but also highlights the risks of inactivity. As youth football participation continues to wane, balancing safety with the benefits of sports remains an unresolved challenge.
