The NFL can't call CTE a "risk" anymore. It's the job's cost

When three out of four people in a workforce are estimated to die with the same brain disease, "risk" stops being the right word. It starts sounding like a euphemism.

That is where the NFL finds itself after a study in JAMA Network Open, which estimates that about 75% of former players who died between 2008 and 2023 had chronic traumatic encephalopathy. As NBC News reports, it is the highest estimate yet, three times the figure the same group published in August. The Boston University team looked at 396 donated brains, of which about 93% showed CTE, plus 1,966 other deceased players. They then corrected for the fact that families of symptomatic players were about five times likelier to donate.

The league's answer was familiar: it "continuously strives to make the game of football safer." That is a sentence, not a plan.

The "uncertain science" defense just lost its best argument

Let's be fair to the caveats, because they are real. This is a model-based estimate. CTE can only be confirmed after death. Russell Lonser of Ohio State, who was not involved, called it "the best attempt so far to correct for selection bias" in CTE brain bank data but stressed it "should be read that way." He also noted there is no comparison group of men who never played contact sports, and that the 75% includes early changes that may never have caused symptoms. Another outside expert, Jim Kelly, pointed out that the estimates rest on far more players without autopsies than with them.

Now look at what survives those objections. Study leader Yorghos Tripodis said that even under very conservative assumptions the estimate does not go below 60%. For comparison, he said fewer than 1% of brains in community-based brain banks show signs of CTE. You can quibble over 75 versus 60. In our view, you cannot build a defense on the gap between 60 and under 1.

We think "we need more research" used to be a reasonable position. Now it works mostly as a delay tactic. The remaining uncertainty is about the exact number, not about the direction. When the disagreement is whether it's three in four or somewhat fewer, the debate has already moved on.

Helmets and kickoff tweaks treat the symptom, not the dose

The league points to redesigned helmets such as the Guardian Cap and the dynamic kickoff rule, which leads to lower collision speeds. Those are fine. They are also marginal, and they don't touch the core of the problem.

Tripodis's own summary is blunt: the more blows to the head over a lifetime, the higher the risk, and reducing exposure to repetitive head impacts reduces it. Notice the word: exposure. Not just "the worst concussions." It is the cumulative, repeated contact that counts. The players in the study averaged five years in the league, and that is only the NFL stretch of a football life that often starts much earlier.

So the logical levers are the ones the league hates talking about: fewer contact reps in practice, tighter limits on live hitting, and a hard look at how many collisions the schedule demands. We think the offseason and practice rules are the easiest place to start, because they cut impacts without changing what fans watch on Sunday. Career length is the uncomfortable one. If exposure is the dose, then a longer career means a bigger dose, and the league can't pretend that is unrelated.

Who pays, and who should push

The NFL Players Association said that studies like this are "critical" and that it is committed to supporting research and expanding access to care. Fine, but care is the back end. Structure is the front end. The union has the standing to bargain over practice contact and workload, and in our view it should treat this study as leverage rather than just another occasion for a statement of support.

The league announced $100 million for player safety in 2016, as ABC News notes, under an initiative called "Play Safe, Play Smart." A decade later, we think the headline number makes that pledge look modest. One caveat the researchers themselves give: the findings apply to deceased former players and may not be representative of living ones. That is a genuine open question. But it cuts both ways. Nobody can currently prove today's game is safe enough, because CTE can't be diagnosed in the living.

Our verdict

Stop calling it a risk. Treat it as a known occupational cost and manage it like one: publish exposure data, cut practice contact further, and put workload and career length on the bargaining table. The league can keep arguing about 75% versus 60%. The more than 20 million men alive today in the US who have played football, as Tripodis noted, deserve a better debate than that.