Freakonomics, M.D.: How Does Playing Football Affect Your Health?

JENA: So, you know, I— I like really wild and crazy ideas. And a few years ago, you approached me with a— a wild and crazy idea. VENKATARAMANI: This was on one of our walks, I think, Bapu, where we talked about this.

That’s my friend Dr. Atheen Venkataramani.

VENKATARAMANI: I’m a physician and a health economist at the University of Pennsylvania.

Atheen and I met in residency at Mass General Hospital, and now we have similar jobs. Unlike me, though, Atheen is a big football fan — he’s been rooting for the Pittsburgh Steelers since he was a kid. And like a lot of football fans, he’s been increasingly aware of the toll the game takes on the bodies of the people who play it.

VENKATARAMANI: Most of the discussion we’ve had up until the last few years has been with the neurological health of football players. More recently we’re thinking about, the stress on the heart that may be adaptive for the game, but it may or may not be adaptive for life after that.

Are years of stress on the heart, repeated blows to the head, and other physical injuries causing N.F.L. players to die earlier than they otherwise would have? What about the health advantages that come with being a professional athlete? So … can we just look at health data for N.F.L. players and compare them to the rest of us? The problem is that they aren’t like the rest of us.

VENKATARAMANI: On average, football players live a lot longer than we do. There’s a lifetime of exercise and preparation and discipline that can have health benefits. And so you wouldn’t want to necessarily try and understand whether professional football can be harmful by comparing a professional football player to you or I or any regular Joe that you know. You need a better comparison.

A few years ago, that’s what Atheen and I set out to find. I’m Bapu Jena, and this is Freakonomics, M.D. Today on the show: How does pro football really affect your health?

VENKATARAMANI: Back in 1987, the N.F.L.’s Players Association held a strike because they were unhappy with some of the rules around free agency and they left for 24 days, about three football weeks. And the N.F.L. owners decided to continue playing N.F.L. games, but they didn’t have players. So they had to find players. And basically local teams went to advertise in supermarkets. They held tryouts. They looked for ex-college players that lived in the area. And they formed these teams of what are called replacement players. it’s kind of a famous episode in N.F.L. history. It was made into a movie called The Replacements. CLIP: Here’s a list of people I’ve been keeping my eye on over the years. They’ve all played football somewhere, not all of them in the pros. But they all have something unique to bring to the game. VENKATARAMANI: The replacement player situation gave us this really interesting natural experiment where you had people that wouldn’t have been in the N.F.L. otherwise play a couple games. And as a result of that, they were recorded in official databases. And so now you have a comparison group of people that credibly were really, really good at football, just didn’t play professionally. And you could compare them against people that actually did play in the N.F.L.

Listen to the podcast episode at Freakonomics, M.D.