May 11th, 2016 12:13 pm ET - Doug Trout, MD, MHS
The question of whether football players are at higher risk of suicide than the general population has been raised in the popular and scientific literature. In 2012, the National Institute for Occupational Safety and Health (NIOSH) published a paper primarily focused on death from heart disease among former National Football League (NFL) players (see related blog NFL Players Tackling Heart Disease). That study reported causes of death for multiple categories, including deaths from suicide.
NIOSH just published Suicide Mortality Among Retired National Football League Players Who Played 5 or More Seasons in the peer-reviewed American Journal of Sports Medicine. This paper provides updated suicide mortality data for the same group of retired professional football players including 6 additional years of data compared to the previous studies. The study evaluated the rates of death from suicide of 3,439 retired NFL players who played at least five seasons between 1959 and 1988. The study found that suicide deaths among this group were significantly less than would be expected when compared to the general U.S. population. We expected to see 25.6 deaths from suicide among the study group however, the actual number of suicide deaths found in the data was 12. The rates of death from suicide of the retired NFL players in our study was less than half of what would be expected when compared with the general U.S. population. In other words, the study found no increase in risk of suicide – and in fact a lower risk of suicide – among retired NFL players when compared with the general U.S. population.
It is important to note that while this study adds to the current discussion as to whether a relationship exists between playing football and suicide risk for former players, it does not resolve the issue. While there is published scientific information concerning a possible association between playing professional football and an increased risk of suicide, other research highlights the limitations in the available information. Though the NIOSH study found no increase in risk of suicide, it does have several limitations of its own. For example, the records available to the researchers did not include any information on other risk factors that are related to suicide – if risk factors for suicide unrelated to playing football were disproportionate in our study population, our ability to draw conclusions concerning football as a risk factor would be impacted. No single study is able to prove a cause-effect relationship. Such relationships are only established based on finding consistent results in a number of similar cohorts, using multiple study designs. As such, more research, with the ability to take into account a wider range of data potentially related to suicide risk among the population being studied, is needed before further conclusions can be drawn.
Lastly, while the question of a connection between football play, concussion and suicide has been raised, this study did not include information on concussions among former NFL players and this research did not draw any conclusions concerning a possible relationship between playing football, concussions, and suicide.
Doug Trout, MD, MHS
Dr. Trout is the Deputy Director of the NIOSH Division of Surveillance, Hazard Evaluations and Field Studies.