Identifying Ethical & Policy Priorities in the Prevention and Management of Chronic Illnesses Associated with Sport-Related mTBI

background/purpose:

The majority of public health scholarship and action connected to sport-related mild traumatic brain injury (“mTBI”) addresses concerns of long-term neuropathologies such as chronic traumatic encephalopathy (“CTE”).  In this context, questions of evidence and interpretation center the significance of neuro-anatomy.  The purpose of this paper is to challenge the dominance of this conversation, and to argue that such an approach deflects needed resources from deeply impairing chronic illnesses – especially pain – for which the causal connection to sports-related mTBI is far less controversial. 

methods:

Scholarly papers as well as commentaries drawn from mass and social media will be reviewed to show the dominance of neuro-anatomy and neuro-pathologies like CTE.  Public health ethics analysis will be used to argue for a specific rank-ordering of priorities in implementing public health interventions regarding health consequences over the life-span of participation in contact sports.

results/outcomes:

The review shows the dominance of neuro-anatomy and neuro-pathology in public health conversations.  Morbidities that are strongly linked with sport-related mTBI and that exact an enormous toll on participants across the life-span (e.g., chronic pain, depression) enjoy comparatively little attention and resources within public health practice and policy.

conclusions:

Analysis of priority-setting in public health shows the current resources devoted to neuro-pathology and neuro-anatomy is ethically suboptimal.  Given the immense burden illnesses like chronic pain cause as well as the quality of the evidence supporting such morbidities’ connections to sport-related mTBI, the allocation of public health resources targeted at the sequelae of mTBI ought to be altered.