Key result
Playing as an NFL lineman is linked to ~49% higher mortality versus matched peers.
Why the study?
Prior findings that professional American football players live longer than general American men may be the consequence of flawed research design.
Does playing professional American football improve or reduce longevity compared to appropriately matched men?
Cohort (n=1,365)
Does playing professional American football improve or reduce longevity compared to appropriately matched men?
Hazard Ratio: 1.49 (95% CI 1.09–2.05)
p-value: p=0.013
When appropriately matched for education and health, playing professional American football does not confer a longevity benefit, and playing as a lineman is associated with increased mortality.
May warrant position-specific monitoring in former linemen; leaves open causal mechanisms and requires prospective confirmation.
Recent research concludes that professional American football players (hereafter, "football players") live longer than American men in general, despite experiencing higher rates of chronic traumatic encephalopathy (CTE) and cardiovascular disease (CVD). This suggests that the longevity-enhancing benefits of playing football (e.g., physical fitness, money) outweigh the costs associated with CTE, CVD, and other longevity detriments of playing football. However, these surprising results may be the consequence of flawed research design. To investigate, we conducted two analyses. In analysis 1, we compared a) all professional American football players whose first season was 1986 or between 1988 and 1995 to b) a random sample of same-age American men observed as part of the National Health Interview Surveys in those same years selected on good health, at least 3 y of college, and not being poor. The exposure consists of playing one or more games of professional football; the outcome is risk of death within 25 y. In analysis 2, we use data on 1,365 men drafted to play in the (American) National Football League in the 1950s-906 of whom ultimately played professional football, and 459 of whom never played a game in any professional league. We estimate the association between playing football and survival through early 2023. In both analyses, we investigate differences between linemen and other position players. In contrast to most prior research, in both analyses, we find that linemen died earlier than otherwise similar men; men who played other positions died no earlier (or later).
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Warren et al. (2023) conducted a cohort in Professional athletes (n=1,365). Playing professional American football vs. Drafted men who never played a professional game (Analysis 2) or matched men from the general population (Analysis 1) was evaluated on Hazard of death (longevity) (Hazard 1.49, 95% CI 1.09-2.05, p=0.013). Playing professional American football as a lineman was associated with a higher hazard of death compared to similar men (HR 1.49), whereas playing other positions was not associated with increased early mortality.
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