What We Can Learn from the Super Bowl to Improve Population Health

This week is all about Super Bowl LVIII, and the Kansas City Chiefs and San Francisco 49ers that have made it to the big game as well as more than a sprinkling of news about a certain pop star.??

Ten years ago, while working at the Centers for Disease Control and Prevention, I wrote a discussion paper for the National Academy of Sciences on Five Lessons from Super Bowl XLVIII for Improving Population Health . After an eventful decade, we’re now at a critical juncture for our nation’s public health system, and this Super Bowl week I’m looking back—as well as forward—to determine which lessons are still pertinent.?

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Lesson 1: Fundamentals?

In the NFL, mastering the fundamentals of football (speed, tackling, blocking, passing and receiving) remain necessary for teams to excel. However, as the game has progressed over the past decade, speed and agility have become even more important differentiators.??

The fundamentals of population health (medical care, public health, genetics, behaviors, social and environmental factors) remain relevant as well, though in my opinion much more has changed in these fundamentals than those in football.??

For example, we’re seeing a growing emphasis on preventative healthcare and addressing the root causes of health issues rather than treating symptoms. The food is medicine movement is an example of addressing what is the root cause of many chronic diseases. Also, advances in data analytics and technology have revolutionized population health management. However, with the rise in artificial intelligence, predictive analytics and other advances, public health and healthcare need more investments in data and a workforce with new skills to meet the challenge.??

In recent years, there’s been growing interest in the foundational capabilities and services provided by public health departments. The State of Indiana stepped up in 2021 through the Governor’s Public Health Commission to take a systemic approach to assess the state’s public health system’s capabilities and services. In 2023, Indiana’s legislature passed historic legislation to transform health departments across the state with new funding and resources.?

Other states are taking note. Last year, legislators in Maryland established the Maryland Commission on Public Health to assess the foundational capabilities of their health departments.?

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Lesson 2: Team effort?

Lessons on teamwork abound in the NFL. While this year’s Super Bowl teams have experienced much success, other teams have experienced letdowns because their teams were not well rounded.??

Public health also depends on a well-rounded team that includes community-based organizations, faith communities, businesses and nonprofits, among others. Successful large-scale and systemic changes don’t happen without strong cross-sector teams, which is crucial for public health success in the future.?

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Lesson 3: Paying for the Quarterback?

Like in 2014, the NFL today continues to reward quarterbacks with big paydays. Have you seen the salaries for Patrick Mahomes, Joe Burrow or Lamar Jackson, all making more than $50 million annually??

The NFL and its 32 teams need strong and diverse funding to afford these salaries. And the league is adept at growing funding, from merchandising and advertising revenue to stadium proceeds and television deals. And let’s not forget Taylor Swift, the world’s most-famous pop star who is dating Kansas City Chiefs player Travis Kelce. The NFL along with the networks and streaming services are loving her big bank as an influencer, bringing in new viewers, fans and merchandise buyers.??

For population health, more funding is needed, and that funding needs to be provided differently than today. Preventing physical and mental disease, addiction and chronic diseases is far less expensive than treatment, but we continue as a country to underinvest in prevention and overspend on treatment.??

According to federal estimates, healthcare spending rose in 2022 by about 4 percent from the previous year to $4.5 trillion in total, equating to $13,493 per person . Compare that to what states, including the District of Columbia, spent in 2021 on a per capita basis, ranging from $7 for Missouri to $371 for the District of Columbia . No wonder we have more deaths from preventable diseases than other industrialized countries.?

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Lesson 4: The 12th Man?

It’s no secret, NFL teams need their fan bases, sometimes referred to as the 12th man.??

Public health is not that different. Both health care and public health experienced amazing support in early 2020 at the start of the COVID-19 pandemic. But that support has faded, and we need to win back those fans.?

Today, our health departments need fan bases that appreciate prevention and health protection to be successful. Public health needs a coalition of powerful, positive influencers from across all demographics in all states to ensure every person in every community in every corner of the country has the opportunity to be healthy.?

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Lesson 5: Visibility and Value (and Communications)?

I wrote in my article 10 years ago that professional football won visibility and value through marketing and branding but also through its drama created in the matchups on the field and in hype and build-up off the field.?

Public health and health care experienced more drama during the pandemic than ever imagined—or wanted. Everyone was watching as the story unfolded and, in the effort to protect population health, officials at times fumbled in their actions and communications, which undoubtedly will happen in a historic response. Fans of football and other sports are passionate and express frustration when their team doesn’t do well, however, come next season most fans are ready to re-engage. The nation’s public health system has had so many “winning seasons” in the past, and I hope fans will come back to cheer on public health again.?

When it comes to communications, I also believe we could take a lesson from Taylor Swift, who is adept at connecting with her fans and extending her fan base. She and her team listen to them, and her fans feel like they are heard.??

To be successful, we in public health must continue to evolve both our messages and how we connect with key audiences—what do these audiences need and what do they want that we are not providing them.?

Continuing to learn lessons?

While much has changed in the past decade, much remains the same—I still believe those who seek to improve population health can learn valuable lessons from the Super Bowl.?

I hope we as a profession take these lessons to heart, gaining appreciation and support for our field as well as, most importantly, successfully promoting safer, healthier and better-quality lives for people across the nation.?

Judy Monroe, MD, is president and CEO of the CDC Foundation?

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THE BIG GAME MVPS

Inspired by Super Bowl LVIII, we’ve drafted our perfect lineup of historical public health most valuable players who have left their mark on the field and society at large. Representing critical work such as implementing a safe and effective polio vaccine, linking smoking and disease in cancer research and developing techniques for blood transfusions, these players skillfully played defense around disease and barriers to equitable health for all.???

Meet the team:???

• Dr. Jonas Salk – The first physician researcher to implement a safe and effective vaccine against polio
• Dr. Alexander Fleming – A Scottish physician who invented penicillin???
• Dr. Ernst L. Wynder – A cancer researcher whose work helped link smoking and disease???
• Lillian Wald – The first person to coin the term “public health nurse” in describing herself and her work in New York City???
• Dr. John Snow – An English physician who is known as the “father of epidemiology” for his ground-breaking work during a cholera epidemic in England???
• Dr. Edward Jenner – The physician who discovered the smallpox vaccine and published his findings for the medical community in 1798?
• Dr. Joseph W. Mountin – The founder of the Centers for Disease Control and Prevention, then called The Communicable Disease Center, in 1946??
• Jessie Sleet Scales – The first Black public health nurse in the U.S. and co-founder of the Stillman House, which worked to improve health conditions in the black community
• Orlean Puckett – An Appalachian midwife who successfully delivered more than 1,000 babies in the late 1800s and never charged for her services
• Dr. Charles R. Drew?– An African-American surgeon and researcher who developed techniques for blood transfusions and large-scale blood banks, saving thousands of Allied forces lives during World War II?
• Helen Rodriguez-Trias – A founding member of both the Women's Caucus and the Hispanic Caucus of the American Public Health Association and the first Latina to serve as president of the organization?