In the summer of 2010, shortly after she graduated from Harvard College, Christine Baugh started working at a neuroscience research lab at Boston University. Young men would come into the lab suffering from chronic pain, depression, and even early signs of dementia. All of these men had something in common: They had suffered repeated head injuries while playing sports like football and hockey. The lab, co-directed by former Harvard College football player, WWE wrestler, and neuroscientist Chris Nowinski, was in the midst of uncovering the full extent to which repeated head trauma had impacted the lives of young athletes. The men Baugh met were trying to find out if they suffered from chronic traumatic encephalopathy (CTE), a condition that was just starting to make headlines in the press.
“There were multiple New York Times headlines about this lab I’d just started working in,” remembers Baugh, “It was an experiment about what I was really interested in—the world reacting to new scientific discoveries.”
In her undergraduate history of science courses, Baugh had discovered a deep interest in the interplay between science and society. Her work in the clinical and neuropathological research labs led by Robert Stern and Ann McKee at Boston University suddenly gave that interest a new dimension: As scientists worked to make the biological connections between head injuries and the varied symptoms that these athletes suffered, a swarm of reporters, politicians, players, owners, and fans started to weigh in on the issue. The debate boiled down to one big question: Does the game of football need to change?
Data and Decisions
After earning a master’s in public health from Boston University and completing a fellowship at Harvard’s Edmond J. Safra Center for Ethics, Baugh began a PhD in health policy at Harvard.
“I wanted to think more deeply about the societal implications—all these ‘should’ questions: How should a parent think about the decision to enroll a child in a risky sport? What responsibilities should a league have with respect to the health of its players?” Baugh says.
To answer those questions, Baugh has traveled around the country surveying NCAA Division 1 football players about their injuries.
“It’s unusual in the PhD program to do that kind of paper-and-pencil survey that a student designs and analyzes herself,” says Laura Hatfield, associate professor of health care policy at Harvard Medical School and a member of Baugh’s dissertation committee. “Christine’s research is also unique because sports medicine is often neglected in the field of health policy.”
In addition to collecting surveys from players, Baugh has gathered existing data about injuries across all NCAA sports and information about how sports medicine programs are funded and structured at the college level. All of this information will help Baugh determine the factors that make college athletes more likely to report head injuries, or to receive the right kind of treatment when they do get injured.
So far, Baugh hasn’t found any easy answers. Many young athletes fail to disclose their injuries to coaches, possibly because they fear losing the ability to play. Forcing injured athletes off the field could disproportionately affect students whose college hopes are tied to sports scholarships—even though continuing to play and get concussed could result in CTE.
The Nature of the Game
“Football is a challenge because it’s one of the few sports, other than boxing or rugby, where contact is an inherent part of the game,” Baugh says. “Athletes hit each other every single play of every single practice and every single game.”
In 2016, the Ivy League eliminated full-contact hits from practices, a decision that Baugh praises as a positive step toward reducing head injuries.
Baugh sees the value in sports at every level of society—she was a co-captain of the Harvard crew team as an undergraduate and calls exercise her “happy place.” She points out that high school and college sports, including football, are an important part of the social fabric of many communities, and youth sports leagues help get kids moving.
However, Baugh cautions that people’s judgment around sports and risk is often clouded by rosy memories of playing on a team as a kid, or being a fan in the stands.
“We need to think carefully about why people are concerned about changing the way a sport is played,” she says. “If your only hesitation to making the game safer is that it changes the nature of the game, then you may be saying that you value a game more than individual or population health. That doesn’t sit well with me.”
Every Player Has a Story
Hatfield says that Baugh’s research has the potential to impact people who play sports at any level of competition. “She is widening the lens beyond the tiny number of people playing professional football to segments of the population who engage in sport and face risk and benefit, but who are not on TV every Sunday,” she says.
Baugh doesn’t just see the big picture, she looks back on the families she met in the CTE lab and remembers how each one of them had their own struggles, their own individual relationship to sports, and to CTE.
“While I’m thinking about the macro public health scale, I have all these people in the back of my mind. Their stories stick with me.”