Race in association with physical and mental health among former professional American-style football players: findings from the Football Players Health Study

Ann Epidemiol. 2020 Nov;51:48-52.e2. doi: 10.1016/j.annepidem.2020.07.013. Epub 2020 Jul 30.


Purpose: Race differences in health are pervasive in the United States. American-style football players are a racially diverse group with social status and other benefits that may reduce health disparities. Whether race disparities in health exist among former professional football players, and whether they differ by era of play, is unknown.

Methods: We examined the association of self-reported race with health outcomes (e.g., physical and cognitive function, pain, depression, and anxiety), among 3747 participants in the Football Players Health Study, comprising former National Football League players who played since 1960. We conducted analyses stratified by age.

Results: Black players had increased risk of all five adverse health outcomes versus white players (risk ratio range = 1.36 to 1.89). Native Hawaiians and men of other races had greater risk of all health outcomes except impaired physical functioning, compared with white players (risk ratio range = 1.25 to 1.64). No clear patterns were observed by era of play. In general, race disparities were not accounted for by health-related exposures during playing years. Adjustment for current BMI somewhat attenuated associations.

Conclusions: Social and economic advantages of playing professional football did not appear to equalize race disparities in health.

Keywords: Anxiety; Cognitive function; Depression; Health disparities; Pain; Physical function; Professional football; Race.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / ethnology*
  • Anxiety / psychology
  • Athletes*
  • Blacks
  • Depression / ethnology*
  • Football*
  • Health Status Disparities*
  • Humans
  • Male
  • Mental Health / ethnology
  • Mental Health / statistics & numerical data*
  • Middle Aged
  • Physical Examination
  • Racial Groups
  • Surveys and Questionnaires
  • United States
  • Whites