|
Abstract
|
Athlete concussion reporting hinges on a fraught and complex series of events, with multiple countervailing interests and in- fluences coming into play. An injured athlete is responding as much to internal motivations as to peers, family, and coaches. Important decisions must be made within this complex web of motives and often in the context of incomplete information. The study by Milroy et al. in the current issue of the Journal of Adolescent Health uses a novel application of an existing theoretical frame to help advance our understanding of athlete concussion reporting [1].
The individual, familial, and societal impacts of brain injury from sport are active areas of biomedical, social scientific, and public health innovation. Science races ahead to more fully understand the pathophysiology of concussion, possible biomarkers of the injury, and the mechanisms underlying the relationship between acute brain trauma and later-life cognitive and behavioral challenges; however, while these advances are being made, those in public health and health policy are left with the task of remediating the problem with incomplete evidence. Indeed, the field of public health is well acquainted with instances of needing to act to prevent undue harms in the face of incomplete evidence. Born out of the public health response related to environmental concerns in the 1970s, the precautionary principle asserts that “lack of scientific certainty must not be used as a reason to ignore or postpone preventive or remedial action when there are other good reasons to do so” or, more collo- quially, “better safe than sorry” [2]. Although state, institutional, and sports league policies in response to sports-related brain injury are an important first step, many existing policies focus on reducing the health burden of a concussion once it occurs rather than reducing the underlying risk of injury [3]. A central tension in creating public health policies is balancing individual liberties with collective re- sponsibilities [4] for health promotion and harm prevention. The context of sports-related brain injury is no different. Some believe that individual choice to participate in these risky activities should be preserved [5], whereas others call for policies to restrict partici- pation or reduce the risk of injury, particularly in the case of children [6]. Beyond this tension, the relative lack of public health policy innovation in this area may be explained by well-documented cognitive biases such as loss aversion and status quo bias [7]. Rather than risk an innovative rule change failing to achieve its intended goal, policymakers prefer to remain with the existing framework even if it has known health consequences ...
Language: en |