by Macey L. Henderson, J.D.

I enjoy watching my favorite NFL teams and players during football season. As the daughter of a local sports attorney who grew up down the street from the Indianapolis Colts complex, I have always been exposed to programs and events that highlight advocacy that the NFL and their respective team markets provide for communities year after year through high profile efforts.

How can the most lucrative sports organization with north of $9 billion revenue help public health? In partnership with the American Cancer Society, the NFL’s A Crucial Catch campaign will again focus the month of October’s on the importance of annual breast cancer screenings particularly for women over 40 years old. The statistics show that 1 in 8 American women will have a lifetime risk of developing the disease.

As screening awareness is the focus of this campaign, the NFL should be applauded for encouraging preventative measures to change behavior and for encouraging the public to seek out screening tests in order to catch breast cancer in its earliest stages. In addition, like other efforts including the Susan G. Komen Race for the Cure, the NFL’s A Crucial Catch campaign can offer greater social support and reduce isolation for people with the disease. These large scale public campaigns fueled by media giants such as the NFL often reach a variety of audiences and can improve levels of support for families and communities.

However, the NFL’s breast cancer awareness efforts have not gone without criticism. The most lucrative organization in professional sports has been accused of not promoting public health, and for even being manipulative. For example, there is a discrepancy between the NFL’s stated goal of promoting screenings for women over 40 and the US Preventive Services Task Force (USPSTF) recommendations. The USPSTF officially changed its recommendation regarding mammography screening by advising that women get mammograms every two years beginning at the age of 50 instead of at 40.

Articles appearing in popular press such as Slate have questioned the NFL’s intentions with the A Crucial Catch campaign, even asking if the effort is better for women, or just football? It is not a necessarily a bad question to pose, especially coupled with the league’s domestic violence crisis in the recent past.

What about the money raised from the NFL-branded pink products (sometimes known as “pinkwashing”)? This has also been an area of criticism, with many media outlets running stories exploring just how much of the money raised by the sale of the NFL licensed products went to support breast cancer research. For example, The Washington Post reported that about 12.5% of sales from NFL-branded ‘pink’ products goes to charity. Sports Illustrated reported that less than 10% of proceeds for the NFL-branded pink products actually supported breast cancer research.

This season, the American Cancer Society CHANGE grants funded by A Crucial Catch will support all NFL team markets. The CHANGE grant program brings education, screening, and follow-up care to people who otherwise might not have access to preventative healthcare. The NFL program grants have educated over 72,000 women on screening and prevention and have provided more than 10,000 free or low cost screening exams. New this year, on October 25, the NFL and partners are teaming up to launch their first nationwide breast cancer event–A Crucial Catch Day.

While I don’t suspect the criticism will end, I do hope we can acknowledge investments that the NFL has made in public and women’s health advocacy. Does the NFL create these campaigns as part of or in tandem with their public relations strategy? Absolutely.

Are campaigns of this nature just distracting from larger ethical issues that the NFL faces such as DeflateGate cheating allegations, domestic violence and player concussions? Perhaps. Marketing and advertising cannot be overlooked here. While there are currently no female players in the NFL, there is one coach, and one referee. Like other corporations, the NFL has the right to work with nonprofits that approach them with projects in line with their mission and target market.

Women are a key target demographic for the NFL and even 2 months after last season’s domestic violence headlines, a record number of women are watching NFL games across all networks.

While these ethical issues in the NFL might not be unique to professional sports, they should at minimum provide the 202.3 million unique viewers, representing 80 percent of all television homes and 68% percent of potential viewers in the U.S., something to think about.

I wonder what kind of additional investments in public health we will see from local team markets? Maybe we will see more investment in youth safety and prevention of head injury in all contact sports in light of the newly released study tying 87 of 91 donated brains of former NFL players to chronic traumatic encephalopathy. Whether the cause for advocacy is women’s health and cancer screenings, concussion and head injury awareness or domestic violence prevention, it is my hope that the NFL remains a big player for public health advocacy.