The Failure of Youth Sports Concussion Laws and the Limits of Legislating Health Education

Abstract

Legislatures have increasingly turned to education-based strategies to address significant public health challenges, despite unclear efficacy of statutory mandated education. In this Article, we examine the recent and rapid adoption of youth sports concussion laws as a lens to explore the limits of education-based legislative intervention models. In less than 10 years, all 50 states adopted a youth sports concussion statute—and each law mandates concussion education for coaches and/or student-athletes. This expansive, expensive intervention was designed to reduce concussion incidence and improve concussion care. But based on a review of 54 peer-reviewed studies, we argue that concussion education has not, and likely will not, produce the desired public health outcomes. The data largely demonstrate that, at most, concussion education can produce short-term changes in knowledge, but that these gains are unlikely to translate into measurable behavior changes that reduce the incidence and risk of concussion in sport. The Article uses public health perspectives to explore the reasons why top-down education interventions from legislatures may fail to have their intended effect. Given these limitations, the Article argues for a new type of concussion education intervention that better aligns with incentives to win, focuses on primary prevention, and promotes culture change in concussion reporting.

Keywords: sports concussions, public health, law and neuroscience, brain, statutes, legislation