• Jeffrey S. Markowitz
Part of the SpringerBriefs in Public Health book series (BRIEFSPUBLIC)


Since race-specific mortality records have been kept for the US general population around 1900, differences in life expectancy have been documented favoring whites over African-Americans. While life expectancy has been significantly extended over time for both races, and the mortality gap between races has narrowed, between-race mortality differences persist. The literature on former professional basketball and football players has also documented mortality differences that favor whites. This chapter analyzes race as a potential risk factor for mortality within- and between- leagues.

A novel, multi-dimensional approach was used to determine the race of former NBA and NFL players that began with books on African-Americans athletes written by Arthur Ashe, Jr. This method was successful in capturing the races of about 86% of all cohort members. Nearly 65% and 45% of NBA and NFL players in the study cohort respectively are African-American.

Within almost all year of birth categories, the percentage of African-Americans who have died is numerically higher than whites within each league. In survival analyses that control for year of birth, African-Americans have a 59% and 34% increased risk of dying within the NBA and NFL respectively and these are both statistically significant. There is no between-league difference on mortality risk when year of birth and race are controlled.

These results provide preliminary confirmation of increased mortality risk within African-American relative to white players that’s consistent with existing literature. Multivariate analyses are required to determine whether these results persist when other key variables are controlled.


Race and mortality Racial disparities in health Race as a risk factor for mortality Mortality gap between races Increased mortality risk in African-Americans Between-race differences in life expectancy Mortality risk within former NBA and NFL players Racial disparities in mortality 


  1. Arias, E., Heron, M., Xu, J. Q. (2016). United States life tables, 2012. National vital statistics reports; vol 65 no 8. Hyattsville: National Center for Health Statistics.Google Scholar
  2. Ashe, A., Jr. (1993a). A hard road to glory: The African-American athlete in basketball. New York: Amistad Press.Google Scholar
  3. Ashe, A., Jr. (1993b). A hard road to glory: The African-American athlete in football. New York: Amistad Press.Google Scholar
  4. Baron, S. L., Hein, M. J., Lehman, E., & Gersic, C. M. (2012). Body mass index, playing position, race, and the cardiovascular mortality of retired professional football players. American Journal of Cardiology, 109, 889–896.CrossRefPubMedGoogle Scholar
  5. Baron, S., Rinsky, R. (1994). Health hazard evaluation report, National Football League players mortality study. Report No. HETA 88–085. Atlanta: Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health. Retrieved from
  6. Benjamins, M. R., Hunt, B. R., Raleigh, S. M., Hirschtick, J. L., & Hughes, M. M. (2016). Racial disparities in prostate cancer mortality in the 50 largest US cities. Cancer Epidemiology, 44, 125–131.CrossRefPubMedGoogle Scholar
  7. Centers for Disease Control and Prevention (2005, January 14). Health disparities by black or African-Americans --- United States. MMWR Weekly 54(1), 1–3. Retrieved from
  8. Centers for Disease Control and Prevention (2013, November 22). CDC Health disparities and inequalities report --- United States, 2013. MMWR Supplement 62(3), 1–2.Google Scholar
  9. Department of Health and Human Services, National Center for Health Statistics, Centers for Disease Control and Prevention (n.d.). National Vital Statistics Reports, Web:; Available online at InfoPlease, Tables entitled Life expectancy by age, 1850–2011 and Life expectancy at birth by race and sex, 1930–2010. Retrieved from and
  10. Epstein, A. M., Ayanian, J. Z., Keogh, J. H., Noonan, S. J., Armistead, N., Cleary, P. D., Weissman, J. S., David-Kasdan, J. A., Carlson, D., Fuller, J., Marsh, D., & Conti, R. M. (2000). Racial disparities in access to renal transplantation — Clinically appropriate or due to underuse or overuse? The New England Journal of Medicine, 343, 1537–1544.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Hacker, J. D. (2010). Decennial life tables for the white population of the United States, 1790–19001. Historical Methods, 43(2), 45–79.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Holowatyj, A. N., Ruterbusch, J. J., Rozek, L. S., Cote, M. L., & Stoffel, E. M. (2016). Racial/ethnic disparities in survival among patients with young-onset colorectal cancer. Journal of Clinical Oncology, 34(18), 2148–2156.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Howard, G. (2014). The big book of African-American quarterbacks. Deadspin. Retrieved from
  14. Institute of Medicine. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: The National Academies Press.Google Scholar
  15. Lawler, T., Lawler, F., Gibson, J., & Murray, R. (2012). Does the African-American-white mortality gap persist after playing professional basketball? A 59-year historical cohort study. Annals of Epidemiology, 22, 406–412.CrossRefPubMedGoogle Scholar
  16. Lehman, E. J., Hein, M. J., Baron, S. L., & Gersic, C. M. (2012). Neurodegenerative causes of death among retired National Football League players. Neurology, 79, 1970–1974.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Levine, D. A., Langa, K. M., & Rogers, M. A. (2014). Acute infection contributes to racial disparities in stroke mortality. Neurology, 82(11), 914–921.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Markowitz, J. (2016). Lost seasons: Arrests, suspensions, career chaos and mortality among National Football League (NFL) players. Jeffrey S. Markowitz, CreateSpace, North Charleston, SC.Google Scholar
  19. National Bureau of Economic Research (1994). Estimated life tables for the United States, 1850–1900. Historical paper No. 59. 1994. Retrieved from
  20. National Cancer Institute (2008). Cancer health disparities. Retrieved from
  21. National Center for Health Statistics (2016). Health, United States, 2015: With special emphasis on racial and ethnic health disparities. Table 19. Leading causes of death and numbers of deaths by sex, race and Hispanic origin: United States, 1980 and 2014. Retrieved from
  22. National Stroke Association (2017). Minorities and stroke. Retrieved from
  23. Park, J. H., & Ovbiagele, B. (2016). Association of African-American race with recurrent stroke risk. Journal of the Neurological Sciences, 365, 203–206.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Sandbox Networks, Inc., publishing as Infoplease (2000–2018), Tables entitled “Life expectancy by age, 1850–2011”. Retrieved from: and “Life expectancy at birth by race and sex, 1930–2010”. Retrieved from:
  25. US Department of Commerce (1921). United States life tables, 1890, 1901, 1910, and 1901–1910. Washington, DC: Washington Government Printing Office.Google Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Jeffrey S. Markowitz
    • 1
  1. 1.Health Data AnalyticsPrinceton JunctionUSA

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