Refereeing the Public Health

41 Pages Posted: 27 Aug 2014 Last revised: 18 Apr 2015

See all articles by Hosea H. Harvey

Hosea H. Harvey

Temple University - James E. Beasley School of Law

Date Written: October 1, 2013


Between January 2009 and October 2013, forty-nine states and the District of Columbia passed "youth concussion" laws focusing on mitigating the consequences of traumatic brain injuries (TBIs) in organized youth sports. Using historical, contextual, and empirical methods, this Article describes the content, goals, and structure of youth sports TBI laws, while hypothesizing about their underlying legislative logic and long-term public health consequences. The Article’s empirical evidence suggests two key findings: first, that a dominant interest group, the National Football League, helped to define the problem and its associated solutions for the vast majority of states, thus curving the legislative story arc in favor of its policy prescriptions; second, that existing youth sports TBI laws are focused on secondary, not primary prevention, and may thus shift attention away from more comprehensive solutions. Finally, the Article explains why such state laws will likely fail to substantially resolve the larger untackled problem — significantly reducing the overall rate and number of TBIs in youth sports. After explaining why existing state youth sports TBI laws fail to accomplish this broader goal, the Article queries whether alternative policy or public health measures might offer more robust solutions.

Keywords: TBI, concussions, youth sports, public health

Suggested Citation

Harvey, Hosea H., Refereeing the Public Health (October 1, 2013). Yale Journal of Health Policy, Law, and Ethics, Vol. 14, No. 1, 2014; Temple University Legal Studies Research Paper No. 2014-41. Available at SSRN: or

Hosea H. Harvey (Contact Author)

Temple University - James E. Beasley School of Law ( email )

1719 N. Broad Street
Philadelphia, PA 19122
United States

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