Why do tall NBA players die earlier?

BarcelonaThe premature deaths of iconic players like Moses Malone, Darryl Dawkins, and Jerome Kersey worried many NBA players. "I always tell my wife that she won't see many seven-foot-tall men walking down the street when she's 75," Larry Bird said in response to these news reports. This concern inspired an investigation into the causes of death and associated risk factors among players in the American professional basketball league. The ten-year investigation has culminated in the publication of three scientific articles. The latest was authored by a multidisciplinary team that included Martí Casals, a researcher and professor at the Faculty of Medicine and the Center for Studies in Sports and Physical Activity (CEEAF) at the University of Vic - Central University of Catalonia (UVic-UCC), Klaus Langohr, from the Polytechnic University of Catalonia, and Julio Sports World"Athletes are our own worst enemy because we don't listen to our bodies, we don't listen to the doctors, and we don't realize it until it's too late," said Bill Walton, a 6'11" player who died a couple of years ago. In fact, the NBA and the players' association reacted in 2016 by creating a plan to conduct checkups for retired players. Research confirms that mortality among NBA basketball players is directly associated with their ethnicity and height. According to the research, players of African descent have a higher rate of cardiovascular mortality, specifically 69% higher compared to players of European descent. According to the researchers, this is possibly due to three main factors: genetic differences that predispose individuals to more aggressive patterns of cardiac hypertrophy, historical inequalities in access to healthcare that persist after players retire, and an inherited socioeconomic disparity, as the lower quality of life for veterans also had a negative impact. In fact, by age 75, the cumulative incidence of death from cardiovascular disease has been estimated at 15% for African Americans and 10% for those of European descent.

The research also shows that a significant percentage of NBA players have unknown causes of death, indicating a structural public health problem and underscoring the importance of specific cardiovascular monitoring for players of African descent, both during their careers and after retirement. Although the study uses advanced statistical imputation, the research team calls for better official records to advance research with social and institutional impact. Indeed, one of the distinguishing features of this study is that the cause of death for each NBA player was manually identified. "This unprecedented approach in sports research is an example of true open science and the collaboration that can exist, for example, between scientists and data journalists," explains Martí Casals. Another parameter analyzed in this search is the height of the NBA players. A relevant finding is that extreme height is a risk factor and acts as an inverse predictor of mortality in athletes. While height protects against heart disease in the general population, in the NBA, every 5 centimeters of additional height increases the risk of death from cancer by 10% and from cardiovascular disease by 13%. Given these figures, scientific evidence also underscores the need for specialized long-term health protocols for exceptionally tall athletes.

The three studies conducted in this research demonstrate that, although NBA players enjoy a longer life expectancy than the general population, "they are not immune to the specific risks derived from their morphology and certain demographic and social factors," explains Martí Casals.

Thousands of players studied

The first study in this research analyzed mortality risk factors in NBA players compared to the general US population. A sample of 3,985 players was used. The second study, which took a crucial step toward transparency and scientific reproducibility by creating an open database, expanded the sample to 4,374 players (412 active and 3,962 retired) from the period between 1946 and 2019. The third and final scientific article compiles the most clinically significant data to analyze the factors associated with the different causes of death. In this case, the study corpus consisted of the 864 NBA players who died up to July 2019.