UC Press Blog

By Kathryn Henne and Matt Ventresca, co-authors of Violent Impacts: How Power and Inequality Shape the Concussion Crisis

This past July, mere days after the start of National Football League (NFL) training camps, a tragic shooting in New York City put the connection between football and brain injury back in the national spotlight. Shane Tamura, a 27-year-old Las Vegas casino worker who played high school football in California, walked into the Manhattan office building where the NFL headquarters is housed and fatally shot four people—Aland Etienne, Julia Hyman, Didarul Islam, and Wesley LePatner. He then took his own life. 

Tamura was carrying a note criticizing the league for giving insufficient warning to its players about the dangers of brain injury. Tamura’s note also requested that his brain be studied for evidence of Chronic Traumatic Encephalopathy (CTE), the neurodegenerative brain disease caused by repetitive head impacts that has been diagnosed in the brains of over 350 dead NFL players. It was a stark reminder of how the relationship between traumatic brain injury (TBI) and football is a hallmark of what has come to be known as sports’ “concussion crisis.”

With greater public awareness of the concussion crisis, discussions about players’ neurological health have often accompanied the beginning of the NFL and college football season. This year, Nsini Umoh, director of the National Institute of Health’s (NIH) traumatic brain injury research program, has published an op-ed declaring, “NFL players, fans are getting serious about CTE. At NIH, we are, too.” Umoh describes advances in CTE science that will improve diagnostic tools and develop potential treatments. Yet the aftermath of the New York shooting has loomed over both the start of football season and Umoh’s words encouraging scientific progress. 

In our book, Violent Impacts: How Power and Inequality Shape the Concussion Crisis, we explore how TBI is a social problem with cultural consequences that reverberate far beyond the football field or research laboratory. Drawing on a decade of research in Australia, Canada, and the United States, our analysis reveals important limitations to dominant concussion crisis narratives primarily generated through three societal institutions: media, science, and law. These institutions maintain powerful influence over how TBI becomes recognized as an issue of social concern and when it doesn’t. We also illustrate how media stories, scientific studies, and legal practices tend to produce narrow conceptions of who is most affected by TBI, how TBI became a public health crisis, and how societies should respond to it. 

Violent Impacts challenges how dominant framings of the concussion crisis largely focus on TBI experiences among elite athletes in men’s collision sports (American football, hockey, rugby, boxing, and Australian football) and, to a lesser extent, youth athletes. While these sports contexts come with considerable injury risk and have raised societal awareness of TBI, many more people experience brain injury without the media or scientific attention afforded collision sport athletes. 

Our book begins by considering the social and political dimensions of TBI in men’s and youth sports. We then extend our analysis to groups of people who are typically not the focus of dominant concussion crisis narratives: women athletes, military servicemembers and civilian victims of military violence, victim-survivors of domestic and family violence, and those who have suffered injuries through police violence. 

Broadening the focus in this way demonstrates how systemic inequalities shape how the “concussion crisis” has emerged as a social problem. Although medical conceptions of TBI tend to revolve around the moment of impact to the brain and its neurological consequences, we are concerned with the social processes that create the conditions for TBI to occur in specific populations. In particular, we explain how TBI experiences are closely linked to forms of structural violence—that is, the ways institutions and political systems cause harm to groups of people—to show how some groups are more likely to be affected than others. 

Critical attention to structural violence not only addresses the exclusions of certain groups from concussion crisis narratives but also sheds necessary light on how social forces come to shape constructions of—and, in turn, responses to—health problems. While scientific knowledge about TBI is important, it should not be the sole focus of how we approach this health problem. By revealing how societal inequities and structural violence shape experiences of TBI across different groups of people, we hope Violent Impacts can point to areas for proactive and preventative measures that extend beyond the brain.