Book excerpt: CTE, Media, and the NFLFraming a Public Health Crisis as a Football Epidemic

Below is an excerpt from "CTE, Media, and the NFL: Framing a Public Health Crisis as a Football Epidemic,'' a recently published book about media coverage of brain injuries in football and other sports. The excerpt is the beginning of chapter eight, which is titled "It's a 'Guy Thing': Mediated Misconceptions,'' and highlights gender disparity in media reporting. The excerpt is being reprinted here with permission from Lexington Books.

CTE, from a media perspective, has not been equitable in sport. The newspaper stories and films included in this book nearly eliminated female-specific sports from any discourse connected to CTE. Newspapers did allow some space for sports such as hockey and soccer that do include female participants. However, when considering who participates professionally in these sports, which receive significant media exposure, hockey, and soccer -- with isolated exceptions for the World Cup -- are still considered masculine sporting spaces. Fink (2015) explained that critical media scholars have suggested “this differential treatment by the sports media is a conscious effort to maintain male power and privilege” (p. 337). In the construction of CTE, the media supported Fink’s assertion and missed nearly twenty at-risk sports for concussions and other brain injuries that have been identified as a precursor to CTE and thus should have space in the conversation about risks of CTE.

Built largely on a cascade of published scientific research, media discourse in the twenty-first century, instead, constructed CTE as a football epidemic. Over the course of CTE as a developing story and thinking back to how HIV/AIDS was framed by media in its early stage as a deviant result of homosexuality or drug use, CTE witnessed strikingly similar positioning connected to an atypical group. Both diseases were perceived to be a result of an individual’s continued participation in an at-risk activity. It was somewhat ironic to see so many parallels between how media framed two diseases across such disparate groups on opposite sides of the masculinity scale. Ultimately, CTE was framed as a diagnosis for men.

As of January 2019, CTE has not been diagnosed in a female athlete. In fact, only two cases of CTE (or at least retroactively labeled) have been diagnosed -- ever -- in a female. A 1990 published report described a domestic violence victim in Britain who showed punch-drunk symptoms (Roberts et al., 1990). Even that case was only tangentially connected based on scientific advances and speculation that the diagnosis would now be CTE. One year later, the second published case was identified in an autism patient who suffered myriad forms of self-injury. The authors noted tangles in unexpected parts of her brain and connected it to similar findings in boxers and soccer players with repeated head trauma (Hof, Knabe, Bovier, & Bouras, 1991). Thus, in nearly three decades since, nothing else connected women and CTE.

This is partially explained because the potential for CTE diagnosis has been limited to available brains. In 2016, Brandi Chastain announced a pledge to donate her brain to the Concussion Legacy Foundation when she dies. The former star of the 1999 U.S. Women’s World Cup championship soccer team was one of the first female athletes to make that pledge. A 2016 story in the Washington Post identified how rare a female brain has been for examination. Of the 307 brains donated to the foundation at BU’s CTE Center, only four were women compared to more than two hundred from former football players (Maese, 2016). Thus, the dataset has been severely skewed toward men, which perpetuated the strengthening force of CTE as an availability cascade that media consistently linked to American football. McKee was quoted in the story, “We currently know so little about how gender influences outcome after trauma” (Maese, 2016, para. 7). However, research showed the potential, if brains become available, both for the study of gender and other sports (Eme, Gilbertson, & Oehler, 2013; Keene, Latimer, Steele, & MacDonald, 2018).

Brain injuries and their symptoms, as well as short- and long-term effects, have been widely addressed concerning professional athletes, especially those in the NFL. As discussed throughout this book, the NFL has remained the most popular American sport despite any threat of perceived, or actual, risk of playing football. While football deserved a significant space in the discussion about brain injuries in sport, due largely to its violent nature, other sports such as basketball, hockey, soccer, and lacrosse should not be ignored. Cantu and Hyman (2012) included these sports among thirteen highlighted as at-risk for brain injuries. Furthermore, these sports have gained traction among young adults and youth leagues through increased participation and have contributed to the growing problem of brain trauma in sport (Bodenner, 2016; Ortiz, 2016; Otero, 2015).

Focusing media attention on football (with hockey and boxing occasionally linked as collision sports) left little opportunity to explore the full scope of brain injury for athletes across all sports, especially in considering gender differences. This was problematic because parents could get a false sense that a non-collision sport could be less likely to lead to brain trauma. Instead, research showed child participation in any sport, regardless of the level of contact, can lead to a concussion (Covassin, Savage, Bretzin, & Fox, 2018; Tanveer, Zecavati, Delasobera, & Oyegbile, 2017). Rather than contribute to the narrative that only collision and contact sports pose a threat to the safety and well-being of youth athletes, differences in brain injuries across sport and gender expand the conversation beyond the NFL as well as to implicate media as part of the problem.

The Co-Authors of CTE, Media, and the NFL are Travis R. Bell, Ph.D., Assistant Professor of Digital and Sports Media and Janelle Applequist, Ph.D. Assistant Professor of Advertising, both at Zimmerman School of Advertising & Mass Communications, University of South Florida in Tampa; and Christian Dotson-Pierson, Ph.D., a speech instructor at the University of South Carolina. For more information about the book and to purchase a copy, visit Rowman and Littlefield.