I read with great interest the recent report on the call for elimination of football from high school argued by Drs. Stephen Miles and Shailendra Prasad (“U doctors call for no football in schools,” Nov. 22). They take issue with the American Academy of Pediatrics (AAP) position statement that tackle football should not be eliminated from youth sports. The AAP position statement instead proposes a series of measures to make football safer — including limiting contact practices, rule changes, improved protective equipment and neck strengthening, among others.

There are several reasons that the AAP statement is reasonable in arguing for continued contact sports, with efforts to render them as safe as possible.

The first reason is that it is impossible to legislate all risk-taking behaviors out of childhood and adolescence. The adolescent brain is not fully developed, and thus not as rigid in its signaling as the adult brain. It is still developing and is wildly creative compared with the more inhibited adult brain. Despite any legislation, children are biologically more impulsive, less restrained and more inclined to take risks.

Football is on the riskier end of the spectrum of sports, but still is less risky than skiing, snowboarding, skateboarding, equestrian sports or bicycling. If we are going to legislate all risk-taking behaviors in children, we should probably begin with those that are statistically most dangerous, rather than those in the middle.

Ultimately, if we do not let our children play football, they may choose to skateboard off the roof. This type of activity is what they are biologically programmed to do.

The second reason not to eliminate tackle football is that it is not entirely clear that elimination of risk-taking behaviors from childhood is in the interest of our society. With football, children learn to assess risk based not only on their own capabilities, but also on the capabilities of their teammates, who protect them and work for their mutual interests. This capacity for rapid risk assessment and plan execution, relying on teamwork and assessment of evolving challenges, may serve our children well in their later professional lives.

Without childhood risk, there might not be adult risk-taking behaviors — no astronauts, explorers, entrepreneurs, fire rescue personnel or surgeons, for example. Helicopter parenting and elimination of all risk may breed a generation of cowards unfit to face the challenges of the next century.

A third reason for the AAP position, clearly indicated in its statement, is that there is not substantive scientific evidence indicating that subconcussive or even concussive impacts in youth have deleterious long-term health effects. The vast majority of children will recover from a concussion without any adverse condition. The greatest risk factor for dementia in American society is vascular insufficiency due to hypertension, obesity and diabetes — all far more prevalent in children who do not exercise. Dementia is also more common in women, who are less likely to have played contact sports.

Within the spectrum of brain-injury-inducing activities contemplated by the developing and unpredictable minds of American youth, football represents an extremely tiny fraction of where risk actually resides. Focused efforts on elimination of football detract from the true preventable causes of brain injury — specifically, gun violence, motor vehicle collisions, and drug or alcohol abuse. Such efforts are also contrary to elimination of the greatest scourge to the health of our modern society — obesity due to inactivity.

The question we should be asking is not whether we should ban football, but how we can encourage more children to be active in the sport of their choice, played as safely as possible.

The AAP has it right — make football safer and get the kids out there playing. Children who want to play football should be encouraged, and those who do not should be counseled to seek alternative exercises that are hopefully at least as beneficial.

 

Uzma Samadani is Rockswold Kaplan Endowed Chair for Traumatic Brain Injury Research at Hennepin County Medical Center and an associate professor of neurosurgery at the University of Minnesota. She is the author of “The Football Decision — An exploration into every parent’s dilemma on whether or not to let a child play contact sports,” which will be published in January 2016.