Let me begin by thanking Dean Julio Frenk for inviting me to speak here today. It is truly an honor to discuss two topics that I am passionate about: the game of football and its future.
The history of football is closely connected with the history of Harvard. Football has been played here with distinction since 1873. Professor Paul Weiler of Harvard Law School persuasively argues that the first college football game took place in Cambridge between Harvard and McGill University.
President Faust paid eloquent tribute to Harvard's football legacy in a speech the night before last year's Harvard-Yale game. She mentioned the university's landmark innovations in the game—uniforms, a team doctor, a trainer, a kicking specialist. Harvard's legacy includes eight national championships and 20 College Football Hall of Famers. Also, the current starting quarterback of the Buffalo Bills—Ryan Fitzpatrick—and Baltimore Ravens center Matt Birk—who last year won the Walter Payton Award as the NFL Man of the Year for his service on, and especially, off the field.
Football is embedded in your traditions, and your contributions have defined and changed how we play the game. We are proud of the connection. And we know that Harvard is proud of your team and players for their extraordinary accomplishments on the football field, in the classroom and in life. From Harvard's first African American football captain, William Lewis in 1893, to Coach Murphy's fine team this year, you have given so much to the sport we love. And good luck to the Crimson this Saturday in "The Game" against Yale, one of football's grandest traditions.
Harvard and the NFL both stand for something else—leadership. Others in education, sports and countless places beyond the playing fields look to us to influence their own decisions. We embrace our leadership position. And leadership means certain things, whether in sports, academia or public health. It means thinking about the long term. It means listening and learning from people, including your critics or those who may be telling you what you don't want to hear. It means facing up to your challenges and working tirelessly to make sure you make the right choices, for the right reasons, based on science and facts, not speculation.
So today, in this place of leadership, I want to speak about our role in protecting the health and safety of athletes—not just in the NFL and football, but in all sports and all levels of play. Our nation is experiencing a public health crisis fueled by growing levels of obesity, particularly in children. You understand the consequences and what needs to be done to reverse the trend. We know kids need to exercise—put simply, to play. And we know that whatever they play, they need to do it safely—with respect for the rules and other competitors, and in support of teamwork and sportsmanship.
Other than my family, my passion in life is football, and always has been. As a kid, it seemed like I was always either playing or thinking about football. The values I learned from the game are central to who I am. I learned about commitment, communication, sacrifice and determination. It was fun, exciting and the ultimate team sport.
Thirty years ago, I joined the NFL as an intern in Commissioner Pete Rozelle's office. I was Pete Rozelle's driver at Super Bowl XX in New Orleans in 1986. I couldn't believe my luck and couldn't imagine a better job. It was the beginning of a dream I am still living. It has been, at times, a humbling journey.
I have been fortunate to preside over the National Football League for seven seasons now. As a League, we continue to achieve great success. A growing number of fans—more than one million a week—attend games at our stadiums. The 16 most-watched TV shows this fall are NFL games—that is, aside from the presidential debates. And they were almost a contact sport, too.
A recent Harris Poll indicated that the NFL's popularity is rising, at an all-time high, and up 12 percent from just 10 years ago. The second most popular sport is college football. The interest is simply amazing—driven by the character of the game, the talent and hard work of our athletes, the dedication of coaches and the passion of our fans.
I don't need to tell you that our nation is sharply divided on many issues. But, as President Obama said just last week, "One of the big unifiers in this country is sports and football in particular. You don't go anyplace where folks don't talk about football."
Football connects generations. Many of us remember watching games with parents and grandparents. We've experienced the joy of introducing the game to our own children. It inspires us to rally around our players, teams and cities. It brings together families, friends and communities. And on a few occasions every year, it brings together the entire country.
Football has earned a vital place in the rhythm of American life. Nearly 6 million kids play flag or tackle football; another 1.1 million play in high school, and 75,000 play in college. For many reasons, I have never been more optimistic about football's future or more confident about its place in our society. Optimistic, but not complacent.
The game of football is thriving. It is more compelling than ever. But it is also seen by some as a game at a crossroads. And not for the first time. We are well aware of social commentators who now question our future. And I am here to tell you: If we are at another crossroads, we have already taken the right path. We took it a long time ago, and our commitment to stay on it will not waver.
The risk of injury in football is well known. Throughout history, football has evolved; it has become safer and safer again. President Faust talked last year about eliminating the dangerous "flying wedge" in the college game more than a century ago. In recent years, there has been a much sharper focus on concussions in football and other sports. There are still unanswered questions, but scientists and doctors know more about concussions and their long-term potential effects than they did even a few years ago. The key issue for us is how we use this new understanding to make the game even safer and more exciting in the future.
I can say in no uncertain terms that this is our biggest challenge: Changing the culture in a way that reduces the injury risk to the maximum possible extent—especially the risk of head injury. We want players to enjoy long and prosperous careers and healthy lives off the field. So we focus relentlessly on player health and safety, while also keeping the game fun and unpredictable.
My most important job is to protect the integrity of the game—but it goes beyond that. It is also to protect the 1,800 professionals who choose to play and who make our game so great.
The responsibility to our players does not end when they hang up their uniform for the last time. The health and safety of former, current and future players involves many facets, not just head injuries. It includes the quality of playing fields, the equipment players wear, rules to protect them from unnecessary risk, programs to support their lives off the field and post-career benefits.
At one time, spinal cord injuries were considered a greater risk than they are today. But after changes in rules and techniques, those injuries have been dramatically reduced. We also have addressed the impact of heat and hydration, better educating our medical staffs and players and supporting the outstanding work of the Korey Stringer Institute. Now we are devoting more resources to the well-being of players as they transition away from the game, including their mental health.
We more than accept this responsibility on total health and safety. We seek it; we pursue it; we honor it. We do it to make a difference in football, in all sports and, we hope, beyond.
I'm sure some of you have asked yourselves the same tough questions others ask: When there is risk associated with playing tackle football, why do people continue to play? And for parents, should I let my kids play tackle football?
These are valid, important questions. Answers can differ from person to person—and especially from parent to parent.
In trying to respond to these concerns, we have looked to the realities of football. We have established an open dialogue—speaking frankly and engaging our critics directly—so that we can improve the safety of football. Whether to play football or any contact sport is a highly personal choice for kids and parents. It must be a thoughtful, informed decision.
The simple truth is that any physical activity comes with risk and reward. Head injuries occur in sports. Earlier this month, many of the world's top sports concussion experts convened in Zurich, Switzerland. It is the leading conference on concussion in sport. In attendance were experts from the International Olympic Committee, international soccer (or as they say "football"), rugby, equestrian competition, Australian Rules Football and many other sports, including the NFL. The chief medical officer of the international soccer federation noted that 300 million people around the world play soccer. Concussions are hardly an issue limited to football or the NFL.
The conference reached a thoughtful consensus on how to advance safety—teach proper techniques and fundamentals; educate coaches, parents and players about concussion recognition and management, eliminate unnecessary contact, and continue to research the unanswered questions surrounding concussions. At the same time, these international experts recommended that sports be played actively, but safely, without regard to age. These few steps will make sports safer for all.
There is no question that there are tremendous benefits to playing team sports like football, whether it's tackle, flag or touch football in the backyard—benefits such as physical fitness, self-discipline, friendships, leadership opportunities, self-esteem, college scholarships and, most importantly, just plain fun.
Presidents from Dwight Eisenhower to John Kennedy to Gerald Ford played and loved football. Business leaders like Jeff Immelt and military leaders like General Ray Odierno learned important lessons from playing football. At West Point, the cadets are required to play a team sport because the experience is fundamental to leadership development.
Is playing tackle football worth the risk? For some, the answer may be no. But millions say yes. We emphatically say yes. And I pledge that the NFL will do everything in its power to minimize the risks and maximize the rewards of this great and increasingly global game.
The way I look at it: Football is always at a crossroads, facing challenges that require leaders to act with courage and purpose to secure and advance its future.
Let's look back at one issue that involved Harvard more than a century ago, in 1905, before the NFL even existed. This was a time when football was extremely dangerous and violent. More than 150 college players suffered serious injuries and 18 players died in 1904 alone—at a time when far fewer athletes played football.
Just think about that for a moment… 18 student-athletes died… in one season, primarily from skull fractures.
The nature of the game at that time led to widespread criticism. In 1903, The New York Times stated that football was trending toward "mayhem and homicide." Some called for ending the sport, including Harvard President Charles Eliot.
The future of football was very much in doubt.
But a Harvard graduate, who happened to be the President of the United States, loved football. And Teddy Roosevelt came to football's rescue.
He had not played football at Harvard, but he loved the game. He saw the merit in the lessons and principles that make football compelling. And in December of 1905, he brought the Big Three—Harvard, Yale and Princeton—to the White House. He convinced them that something had to change. President Roosevelt recognized that the game did not need to end. It needed to evolve.
As a result of President Roosevelt's initiative and the leadership of Harvard, key rules and the equipment of the game were changed and what became the NCAA was created. This led to modern football, one that included the forward pass, 10 yards for a first down and the elimination of the flying wedge. These changes led to a more wide open, safer game.
Teddy Roosevelt helped transform a sport in trouble into something better—a game that has helped shape the lives and careers of generations of young men in so many positive ways.
In 1910, President Woodrow Wilson observed that the changes were working. "The new game of football seems far more enjoyable than the old one," he said. "The new rules are doing much to bring football to a high level as a sport, for its brutal features are being done away with and better elements retained."
So it was that a Harvard graduate and the university itself played a pivotal role in transforming football and paving the way to its future success.
The game has continued to evolve. Not long ago, the game allowed the head slap, tackling by the face mask, horse collar tackles, dangerous blocks and hits to the head of defenseless receivers and quarterbacks. All of that has changed.
"The war against roughness in pro football is a continuing one," said the NFL Commissioner. That was Pete Rozelle in 1963.
"An Unfolding Tragedy." That was a headline. The story said, "As football injuries mount, lawsuits increase and insurance rates soar, the game is headed toward a crisis, one that is epitomized by the helmet, which is both a barbarous weapon and inadequate protection." It was a Sports Illustrated cover story in 1978.
Protecting the health and safety of players has included taking drug abuse and steroids out of the game. We have randomly tested year-round for steroids since 1990, the first League to do so, with immediate suspensions for any violations. Next, we need to implement testing to make sure human growth hormone is out of the game. Performance enhancing drugs are dangerous. They also present unknown risk that may be seriously impacting an athlete's health in ways he or she never considered. Some have suggested that there may be a link between performance enhancing drugs and concussions and brain disease.
Football has always evolved and it always will. Make no mistake: change does not inhibit the game, it improves it.
It's with Teddy Roosevelt in mind that we embrace today's challenges. I learned a long time ago that you don't do things because they are popular in the short term. You do them because they are right for the long term. And this is the right conversation to be having.
My commitment has been and will continue to be to change the culture of football to better protect players without changing the essence of what makes the game so popular.
It has been done. And it will be done.
As stewards of the game, it is our responsibility to promote a culture of safety. To be leaders. So let me share with you some specifics on how we are leading.
Leaders do not sit and wait for others to provide answers. We will continue to make rule changes, invest in innovative protective equipment and provide our medical staffs the tools and authority to protect players on the field.
The rule in our League is simple and straightforward: Medical decisions override everything else. There has been attention this week on the fact that three NFL quarterbacks sustained concussions last Sunday. The positive development was that all three were taken out of the game as soon as they showed symptoms. The team medical staff then diagnosed a concussion and each player was out of the game. That is progress. That is the way it should be in all sports at every level.
We know that our actions set an example. The concussion awareness material and training videos we developed with the Centers for Disease Control were used by the U.S. Olympic team this past summer. The United States military, NASCAR and college conferences have adopted our concussion protocols.
The Ivy League this year adopted rules similar to the ones in the new agreement with our NFL players, limiting contact in practices and emphasizing taking the head out of the game—as we have been doing.
High schools and colleges must take leadership roles as well with their coaches and athletes. An aggressive dialogue and educational efforts at all levels will raise awareness and change the culture to more strongly emphasize safety. We challenge everyone in sports to be agents of culture change. And we will learn from each other.
There is more to be done. And we will continue to lead by example.
Second, leaders base decisions on facts. We actively support independent and transparent medical research. Much of this focuses on the brain, sometimes called the last frontier of medicine and a public health issue that affects millions. Most of them do not even play sports.
We hope our focus on brain injury and the discoveries ahead will benefit the broader population. We recently committed $30 million to the National Institutes of Health for research on the brain. The agreement with our players sets aside an additional $100 million for similar medical research over the next decade. We have invested millions more in medical research through our charitable foundations, including at the Boston University Center for the Study of CTE. The center's Co-Director, Dr. Robert Stern, is here today.
We may learn through breakthroughs in science that there are genetic or other factors that make certain individuals predisposed to concussions or brain disease. If an athlete has repeated concussions or takes longer to recover, it may signal a problem unique to that individual. Such individuals will benefit from advances in the science of concussion. They will be able to make more informed decisions about whether to accept the risk of playing a contact sport.
We support research into new helmet designs and have sponsored independent helmet testing to provide better information to players on helmet performance. One of the helmets our players wear was designed by a former Harvard quarterback, Vin Ferrara.
We may see a day when there are different helmets for different positions, based on which helmet can best protect players at their position.
As a sport that is on the national stage and under the spotlight, we are working to make a difference. Innovations in research today will improve safety in the sport tomorrow and for future generations in all sports.
Third, we are committed to strengthening our playing rules—and insisting on strict enforcement. Preserving the essence of the game, while reducing unnecessary risk, means we have to constantly reevaluate and refresh our rules reasonably and responsibly.
Strategy, strength and speed are what make the game great. We don't want to take physical contact out of the game. But we must ensure that players follow rules designed to reduce the risk of injury. Enforcing rules on illegal hits to the head with fines and suspensions has changed tackling for the better. Players and coaches have adjusted. They always do. We now see fewer dangerous hits to the head and noticeable changes in the way the game is being played.
We continue to look for other ways to take the head out of the game. Two years ago we moved the kickoff line five yards forward to the 35. That reform yielded real benefits—a 40-percent reduction in concussions last year on kickoffs. College football then adopted our rule. Some think that the kickoff—the play with the highest injury rate—should be eliminated from the game or modified even further.
Here's an idea I've heard from an NFL head coach: put a weight limit on players for kickoffs. Smaller players against smaller players would mean less severe collisions.
We will monitor the data on kickoffs and all plays with an open mind toward change.
Our Player Safety Panel, co-chaired by Hall of Famers Ronnie Lott and John Madden, has recommended that our Competition Committee carefully review the rules on all blocks below the waist. Protecting "defenseless" players started decades ago by banning the hitting of kickers. We now have nine separate categories of defenseless players in our rule book. All players can be defenseless in certain situations and we must address it comprehensively.
The right safety equipment is also crucial. Next year, NFL players will be required to wear knee and thigh pads, as players are required to do at every other level of football. Many NFL players haven't been wearing them. Getting them into the right equipment is part of changing the culture.
Technology is also helping us. Recent developments include new protocols, certified athletic trainers in press boxes to serve as spotters for team medical staffs and the use of iPads and cell phones by medical staffs on the sidelines. We allow this technology for medical reasons, but not for competitive purposes.
We are testing accelerometers in helmets. They are sensors that determine the impact of a hit. We are also testing sensors in shoulder pads which could provide important information.
The most significant innovation may be the use of video by medical staffs on the sidelines to evaluate the mechanism of injury. We started it late last season and now use it for every game. It allows team doctors and trainers to more quickly understand and better treat an injury. Our team medical staffs are raving about it.
Fourth, we use our leadership position to advocate for safety in sports. We took a lead role in supporting the Zackery Lystedt Youth Concussion Law. It applies to all sports. It requires education for coaches, players and parents, removal from games or practice for any school athlete who suffers a concussion and clearance by a medical professional before the athlete can return to play. This law has now been passed by 40 states and the District of Columbia. Our goal is to secure approval in all 50 states. And I am confident that we will get there.
We are committed to the safety of young athletes, starting as soon as they step on the field. My twin daughters in middle school play lacrosse and soccer. Girls' soccer has the second highest rate of concussions in youth sports. I am concerned for their safety. I want them to play, but I want them to play for coaches who know how to teach proper techniques and who are trained in the safety of their sport.
Ten years ago, we helped endow a non-profit organization called USA Football. With the CDC and other medical and football experts, USA Football created the only nationally accredited coaching course in the history of football. Tens of thousands of coaches have completed the course. Better certification and background checks of all coaches must be among the highest priorities for all youth sports.
USA Football has commissioned an injury study—research that the youth game has never seen. It also established a pilot program this year called "Heads Up Football." This program invites parents to participate and delivers training and education for safer tackling, practice regimens modeled on the NFL and a safety coach whose sole task is to monitor and ensure player safety in practices and games.
In fact, there is a critical need for more certified athletic trainers for youth and high school sports. According to the National Athletic Trainers Association, in 2010 only 42 percent of high schools had access to certified trainers who were trained in concussion care.
There is more we can do to make youth sports safer. And again, we stand ready to lead.
And finally, we know we can't do it alone. To learn what needs to be learned and do what needs to be done, we need partners with expertise to make things happen.
We will continue to work with leading organizations to support independent research. One day we hope that will include the Harvard School of Public Health.
We have assembled an all-volunteer advisory panel of doctors, scientists and thought leaders in brain injury from academia, sports medicine, engineering, the NIH, CDC and Department of Defense. It includes some of our earlier critics. This group has four subcommittees and is directing discussion and research—ranging from long-term outcomes to education to making safer equipment. It includes another Harvard graduate and former Crimson football player, Dr. Mitch Berger. Dr. Robert Cantu, long respected in this area, is here today and he is an advisor to our committee.
We have eight other medical advisory committees within our League, comprised mostly of doctors plus other experts from inside and outside the League. These committees are overseen by a committee of owners chaired by an NFL owner who is also a physician, Dr. John York of the San Francisco 49ers.
Earlier this year, with the help of the Consumer Products Safety Commission, we launched a pilot program to replace helmets in underserved schools.
We need to be driven by facts and data, not perceptions and suppositions. The National Institute of Occupational Safety and Health (NIOSH) has done studies on NFL players. This summer NIOSH exploded a myth that has been circulating for years that the life expectancy of NFL players was 55 years of age. That caused many NFL players to make a bad decision to take their pension early at a much lower rate. NIOSH found that the true life expectancy of an NFL player is actually longer than the general population. There are real-life consequences when working off bad facts.
One of our most exciting and innovative new partnerships is with the Army, helping to change the culture in both organizations. Too often, bravery and commitment to the unit or team stand in the way of safety. In this new partnership, NFL players and service members are working together to put in place a culture of safety. It is helping players and soldiers identify the signs and symptoms of brain injuries, and empowering them to make better decisions. We are working cooperatively to make soldiers and athletes safer.
We are proud to be leaders in sports health and safety. Members of Congress, former critics, influential members of the news media, and others have praised our initiatives. But while we have worked hard throughout our history, the right road is never ending. Evolution, by nature, does not stop. Football will always continue to evolve.
The culture of the athlete is still too much of a play-through-it, rather than player-safety mentality. Many players have publicly admitted to hiding concussions and other head injuries.
I was recently at dinner with family friends. Their 15-year-old daughter plays field hockey and told me how during a recent game she hit her head on the turf and blacked out for a moment. She didn't tell anyone because she didn't want to come out. The next day she was diagnosed with a concussion. It's the warrior mentality—in a 15-year-old girl. This is unfortunate, but we are working with players, team doctors and coaches to change that culture. It is changing, but will take more time, resolve, patience and determination.
Let me conclude with a question: What is our goal? I can answer in one simple word: Safety.
A safer game for all who play at every level of football. A safer game made even more exciting through thoughtful adjustments of the rules, next-generation equipment, pioneering research and transparent partnerships with the best minds.
The road may be long and twisting. But I have no doubt we will reach our destination—a culture of safety for every sport so our world continues to be blessed by the vital and vibrant rewards that come uniquely from sports. For football, I can say with humility, resolve and confidence: the best is yet to come.