Effects of playing high school football on cognition and mental health in early adulthood: An observational study


Hasegawa, Raiden; Deshpande, Sameer; Weiss, Jordan; & Small, Dylan (2018). Effects of playing high school football on cognition and mental health in early adulthood: An observational study. 2018 Add Health Users Conference. Bethesda, MD.


More than 1 million students play high school American football annually, but many health professionals have recently questioned its safety or called for its ban. These concerns have been partially driven by reports of chronic traumatic encephalopathy (CTE), increased risks of neurodegenerative disease, and associations between concussion history and later-life cognitive impairment and depression among retired professional football players. A recent observational study of a cohort of men who graduated from a Wisconsin high school in 1957 found no statistically significant harmful effects of playing high school football on a range of cognitive, psychological, and socio-economic outcomes measured at ages 35, 54, 65, and 72. Unfortunately, these findings may not generalize to younger populations, thanks to changes and improvements in football helmet technology and training techniques. In particular, these changes may have led to increased perceptions of safety but ultimately more dangerous styles of play, characterized by the frequent sub-concussive impacts thought to be associated with later-life neurological decline. In this work, we replicate the methodology of that earlier matched observational study using data from the Add Health study. Since a direct comparison of football players' outcomes and non-football players' outcomes is susceptible to confounding, we first use propensity-score matching to match football players to non-football players along a range of baseline variables measured in Wave I. These include adolescent and family comorbidities, academic experience, self-reported levels of general health and physical activity, and the score on the Add Health Picture Vocabulary Test. Our two primary outcomes are the CES-D score and the scores on the word recall test administered in Wave IV. We also examine several secondary outcomes related to physical and psychological health, including suicidality. Our results can provide insight into the natural history of any potential football-related decline and dysfunction.

Reference Type

Conference proceeding

Book Title

2018 Add Health Users Conference


Hasegawa, Raiden
Deshpande, Sameer
Weiss, Jordan
Small, Dylan

Year Published


City of Publication

Bethesda, MD

Reference ID