Small School Football 2.5x More Risky

Your son or daughter wants to play high school football. Then make sure they attend a big school—the bigger the better.

Players from small schools face more than double the risk of injury—including concussion—than do those on the teams playing for the largest schools said Lauren Pierpont, a graduate student at the University of Colorado, Denver who spoke on the subject at the American Public Health Association annual meeting.

Pierpont and her colleagues tracked high-school football concussion data for the school years 2005-2006 to 2016-2017. The data came from 711 schools and covered almost 34,000 injuries, including 7,023 concussions, according to Randy Dotinga, a contributing writer for Med Page Today.

The researchers found (and Dotinga reported in this story) that the smallest teams—those in the 10th percentile—had 2.5 times greater risk of injury than those in the largest teams (90th percentile). The risk of concussion was similarly high and correlated with school size.

To estimate the sizes of the teams, the researchers used “athletic exposures,” which was a measurement of how often athletes were exposed to play in practice or games.

Results were similar when the researchers adjusted the definitions of smallest and largest teams. “No matter what, if you’re at a smaller school, you have a larger rate of injury,” Pierpont said to Dotinga.

What to take away from this study?

One possibility would be to make schools larger. Pierpont suggested, when asked by Dotinga, that school or political administrators boost team size by consolidating teams from various schools, “especially if participation in football keeps declining,” she said.

Football is the most popular high school sport, although participation has dipped markedly since 1998, possibly because of a public focus on concussions and safety.

Football is among the riskiest of the high-school sports.