Whether playing football can contribute to a longer life has evolved from a casual debate to a significant epidemiological inquiry. Recent research indicates that elite athletes, including footballers, often outlive the general population, primarily due to reduced rates of cardiovascular diseases and certain cancers.
In collaboration with Maxime Sellers, John Orchard, and Jessica Orchard, I contributed to a study examining the longevity of 20th-century professional male English footballers compared to other English men. Our findings suggest that these athletes generally enjoy a longer lifespan, albeit with some nuances.
Elite Athletes and Longevity: The Broader Perspective
Several large-scale studies and meta-analyses have consistently shown that elite athletes tend to live longer than non-athletes. For instance, research by Garatachea et al. (2014) revealed that top-level athletes have lower all-cause mortality and reduced risks of cardiovascular diseases and cancer compared to the general population.
Similarly, Kettunen et al. (2015) found that former Finnish elite male athletes had a life expectancy five to six years longer than men who were already healthy in their youth, largely due to lower cardiovascular and tobacco-related cancer mortality.
These studies highlight the survival advantages conferred by high levels of physical activity, better baseline health, and lower smoking rates. However, most of these studies included athletes from various sports, leaving football-specific risks and benefits less clear.
Examining 20th-Century English Footballers
Study Overview
The study analyzed the mortality of 7,620 male professional footballers who played for the top 25 English Football League clubs during the 20th century. Players born between 1900 and 1972 were included, ensuring their careers began after World War I and before the Premier League era.
Key methodological details included:
- Data Sources: Player birth and death data were obtained from Wikidata and verified against other public databases.
- Follow-up: Deaths observed between 1963 and 2022 were recorded.
- Comparator: Age-specific and year-specific mortality rates for English men from the Human Mortality Database and the Office for National Statistics.
- Outcome: Standardised Mortality Ratio (SMR) = observed deaths / expected deaths.
By the end of 2022, 3,571 players had died, while 4,049 were still alive. The expected deaths in an age-matched English male population were 4,242, resulting in an overall SMR of 0.84, indicating a 16% lower death rate among footballers.
Age-Specific Patterns
The age-stratified analysis revealed that footballers had lower mortality rates than age-matched English men in most age groups. However, the 80–89-year age group showed a slightly higher SMR, suggesting increased mortality compared to the general population in those ages.
This pattern indicates that while footballers enjoy a survival advantage in younger and middle ages, this benefit diminishes and may reverse in older age, a trend seen in other football cohorts.
Comparisons with Other Football Cohorts
Our findings align with broader research on football-specific longevity. For instance, Orchard et al. (2022) studied elite Australian Rules footballers and found a 21% reduction in expected deaths, with a pronounced advantage for players under 50.
Similarly, Orhant et al. (2022) reported lower all-cause mortality among French professional players, although they noted higher mortality from dementia-related causes.
These studies suggest that while footballers may live longer overall, they might face increased risks for specific conditions, particularly neurodegenerative diseases.
Position-Specific Longevity
Research by Śmigielski et al. (2020) indicated that goalkeepers tend to live five to eight years longer than outfield players, suggesting that role-specific physical demands within football may influence longevity.
Why Might Footballers Live Longer?
The longevity of footballers can be attributed to several factors consistent with broader elite-athlete literature. Professional footballers undergo rigorous training, which provides cardiometabolic benefits such as improved cardiorespiratory fitness and reduced cardiovascular risk.
Additionally, footballers are often selected from fitter adolescents and undergo medical screening, contributing to the “healthy worker effect.” Historically, they likely smoked less and maintained lower BMI than the general population.
Socioeconomic factors also play a role, as professional football often correlates with higher income, social status, and access to healthcare, all of which strongly influence survival.
Important Caveats and Risks
While the headline “footballers live longer” is comforting, it conceals important subtleties. The research involves inherent healthy cohort/selection bias, comparing footballers with the general male population rather than equally healthy non-athletes.
Moreover, the French cohort’s excess dementia mortality highlights a potential increased risk of neurodegenerative diseases among footballers, a concern echoed in other studies.
Our research indicates that while footballers generally live longer, this advantage is not linear. The slightly higher SMR in the 80–89 age group suggests that benefits earlier in life may be offset later. Additionally, the study focused on 20th-century players, and modern professionals face different challenges, so identical outcomes cannot be assumed.
As research continues, understanding the balance between the benefits and risks of a football career will be crucial in shaping training, healthcare, and post-career support for athletes.
