Ben McGrath has an excellent article on “the NFL and the concussion crisis” in the January 31st issue of the New Yorker. It’s well worth a read (though it might change the way you see the Superbowl), but the thing I want to highlight is the roles of Alan Schwarz and the New York Times in raising the public’s awareness of a problem that pervades football. (For our international readers, I’m referring to the US version of football – I realize that word means something different in the rest of the world.)

Specifically, the problem is the effects of repeated brain trauma, which football players often experience during games and practice alike. McGrath gives a snapshot:

Chronic traumatic encephalopathy, or C.T.E., is the name for a condition that is believed to result from major collisions–or from the accumulation of subconcussions that are nowhere near as noticeable, including those incurred in practice. It was first diagnosed, in 2002, in the brain of the Pittsburgh Steelers Hall of Fame center Mike Webster, who died of a heart attack after living out of his truck for a time. It was next diagnosed in one of Webster’s old teammates on the Steelers’ offensive line, Terry Long, who killed himself by drinking antifreeze. Long overlapped, at the end of his career, with Justin Strzelczyk, who was also found to have C.T.E. after he crashed, fatally, into a tanker truck, while driving the wrong way down the New York Thruway.

Knowledge of this problem might have remained limited to the medical and football community if Chris Nowinski – “a Harvard football player turned pro wrestler turned concussion activist” – hadn’t convinced his freelance-writer friend Alan Schwarz to pitch the story to New York Times Sports editor Tom Jolly. Then, the Times made a few of crucial decisions.

McGrath explains that Jolly could’ve assigned the story to one of his staffers, but instead asked Schwarz, who’d been writing Sunday sports columns about statistical analysis. Nowinski told McGrath that writers who covered football hadn’t wanted to touch the story, because they didn’t want to lose their access to important sources. Schwarz, on the other hand, wrote about baseball and didn’t seem to care about upsetting the football establishment – whose reaction to Schwarz’s stories “was not warm.”

In early 2007, Schwarz wrote a series of articles that the Times ran on the front page:

“Expert Ties Ex-Player’s Suicide to Brain Damage from Football,” 1/18/07
“Dark Days Follow Hard-Hitting Career in N.F.L.,” 2/2/07
“Wives United by Husbands’ Post-N.F.L. Trauma,” 3/14/07

Then came the next crucial decision by the Times. McGrath writes:

Glenn Kramon, an assistant managing editor at the Times who oversees long-term, Pulitzer-worthy projects, read this piece and decided to intervene. Schwarz was given a full-time position, with no responsibilities other than to broaden his new beat’s focus beyond the N.F.L. to the more than four million amateur athletes who play organized football. Although Schwarz was assigned to the sports desk, the Times framed the story as a matter of public health, akin to tobacco, asbestos, and automobile safety. Schwarz covered high schools, helmets, workmen’s comp, coaching, and so on, earning the nickname Alan Brockovich among friends.

McGrath explains that the articles threatened to diminish the pipeline of future football players, and one ESPN writer characterized the NFL’s feeling as “This guy’s out to get football.” The League’s response has evolved over the past few years, though; NFL medical adviser Dr. Joseph Maroon characterized their reaction to the problem of brain damage as shifting from active and passive resistance to passive acceptance and finally to active acceptance.

Although the NFL’s response might not be all that the public health community would hope for, they took a major step last July when they produced a locker-room poster stating that “concussions and conditions resulting from repeated brain injury can change your life and your family’s life forever.” In his article on the event, Schwarz called it “by far the N.F.L.’s most definitive statement on the cognitive risks of football.”

Everyone interested in football (as entertainment, a public-health issue, or both) should read McGrath’s article for more on how the NFL is addressing this challenge; the New York Times’ archive on football and concussions is also a great resource. The point I want to make here is that the NFL probably wouldn’t have been making these kinds of changes right now if it weren’t for Schwarz’s series of articles. McGrath’s piece makes it clear that in addition to Schwarz’s talent and dedication, vision and support from the New York Times’ Tom Jolly and Glenn Kramon were essential to the project.

How many newsrooms today have the resources to support this kind of reporting? A look at recent winners and finalists for the Pulitzer Prize in Public Service and Investigate Reporting shows that in-depth, top-notch reporting that benefits the public good still happens. As newspapers downsize, though, fewer journalists will have opportunities like the one Schwarz had at the New York Times. I’m glad to see nonprofit organizations like ProPublica – which won a 2010 Investigative Reporting Pulitzer for Sheri Fink’s work on life-and-death decisions made by doctors cut off by Hurricane Katrina floodwaters – developing a model of journalism that doesn’t rely on selling ads in print publications. As we decide what to read and whether to subscribe to different news outlets, we should remember that good journalism plays an important role in improving public health.