Study of NFL Players Reveals Racial Disparities in Pain

Black former National Football League players report worse health and more intense pain, despite being younger than their white counterparts, a new study reveals. The findings suggest that race-related disparities in pain remain even among professional athletes.

Chronic pain affects over 100 million adults in the United States, but the burden is unequally distributed across racial and ethnic groups. Although African Americans experience a greater prevalence and severity of chronic pain compared to white adults, they have poorer access to high-quality pain care.

A new study published in the peer-reviewed journal Pain examined the association of race with pain outcomes among 3,995 former National Football League (NFL) players who held a contract in 1960 or later. Of those, 1623 (40.6%) self-identified as Black, and 2372 (59.4%) self-identified as white.

The study found that Black players reported more intense pain and higher pain interference with daily activities, despite being younger than white players, 48 and 54 years old on average, respectively.

Using questionnaires, the researchers collected players’ demographical data, the number of seasons they played professionally, and their field positions. They also used scales assessing pain intensity and interference in daily life activities such as working and socializing in the past 7 days.

Black players were more likely to report chronic conditions such as hypertension, diabetes, and sleep apnea and carried a more significant burden of concussion symptoms. Fatigue was more severe among Black players, who also had a lower endorsement of social support. Both of these factors were more strongly related to pain in Black players.

The smoking rates were higher, and the exercise rates were lower among Black players. They were also more likely to have comorbid anxiety and depression compared to white players. Depression is associated with elevated pain intensity among Black players but reduced pain intensity among white players. This may be because white Americans are far more likely than Black Americans to be screened and treated for depression.

Although former Black players reported higher body mass indexes (BMIs), higher values were associated with more pain only among white players.

However, the authors say they were unable to evaluate the causal direction of the associations observed in the study. For example, the relationship between pain and fatigue can take a number of forms. Additionally, the study did not fully investigate the multidimensional mechanisms contributing to pain disparities, such as players’ financial situations or the duration of their pain complaints.

Chronic pain refers to pain that lasts for three months or longer. The condition has significant clinical and social consequences. According to a 2017 study, about one-third of participants with chronic pain in multiple sites have mild or major depressive symptoms. One in four (26%) of participants reported pain significantly interfering with general activity, while one in five (18%) said it dramatically reduces the enjoyment of life. Chronic pain was also associated with loss of work productivity, an average of 5.4 hours per week.

The study of NFL players concludes that the substantial social and economic advantages of working as a professional athlete appear not to erase race-related disparities in pain.