Overshadowed by August’s unprecedented wildcat strikes in professional sports, an equally significant labor action went relatively unnoticed. On August 25th, two former National Football League (NFL) players filed a lawsuit against the league in federal court, arguing that the diagnostic test used to determine compensation in the concussion settlement discriminates against Black players. The plaintiffs, Kevin Henry and Najah Davenport, contend that the settlement uses different standards for Black and white athletes through a practice called “race norming.” According to the complaint, when testing for neurocognitive impairment, Black players’ raw scores are adjusted using a “Full Demographic Model . . . which includes age, education, race/ethnicity, and gender.” Black men in the case are assumed to start with a lower level of cognitive functioning than their white counterparts and as a result, if a Black and white player receive the same score, the Black athlete is assumed to have less impairment.
Former defensive lineman Kevin Henry received two neurological evaluations and two sets of scores. His first score was not adjusted for race or its proxy—level of education—and Henry was found to suffer serious cognitive impairment. The NFL denied his claim and when Henry’s score was race normed, less cognitive loss was determined, consigning him to a lower level of compensation. Retired running back Najah Davenport’s first round of testing also qualified him for damages. The NFL appealed his award, arguing that his scores had not been race normed; when they were Davenport’s cognitive decline was insufficient for payment.
Race norming (also called “race correction” in medicine) involves the adjustment of values for health or organ functioning in Black patients based either on a white norm or on the use of different standards for Black and white patients rather than one standard for all. It is widespread in nephrology, pulmonology, cardiology, and neuropsychology. In nephrology, for example, a multiplication factor is applied to Black patients, again using the kidney function values of people identified as white as the norm. In pulmonology, race correction applies a multiplication factor to the reference-values of white populations or uses “population-specific” standards. Race-based algorithms are common in cardiology and, as it turns out, neuropsychology. Providers are often not at all aware they are adjusting by “race”.
Unaware as providers may be, the effects of race correction are considerable and dangerous. In kidney function tests, race norming affects eligibility for kidney transplants, and in lung function tests, the practice shapes determinations of disease severity and attendant treatment plans, access to disability, and compensation payments. In neuropsychology, race correction requires Black patients, like the retired NFL players in the lawsuit, to show more cognitive decline than their white counterparts in order to qualify for the same levels of compensation. More perniciously, race correction is founded on the assumptions that races are homogeneous groupings and that fixed or unchangeable racial differences exist, whether produced by genetics, social-cultural environment, or both.
It has also been fought in the legal system. Foreshadowing the NFL players’ suit, race correction was challenged in a lawsuit against the asbestos industry in the late 1990s. Lawyers for the insulation manufacturer Owens Corning submitted a motion to race correct the lung function tests of Black shipyard and steel workers in Baltimore, MD. Black workers contested company efforts, and the presiding judge agreed to bar its use in the settlement. Though one case with limited scope, the settlement brought the practice to some public attention for the first time.
The current lawsuit against the NFL represents one more twist in a labyrinthine settlement that has been plagued by problems from the outset. It illuminates the never-ending lengths to which the NFL will go to deny former players access to benefits. In a moment when Commissioner Roger Goodell publicly asserts that the league cares about Black athletes, behind closed doors, it actively works to reduce their eligibility for awards.
But the case brought by retired Black football players also has the opportunity to confront race norming once again, this time in neurocognitive tests. The NFL case can draw attention to a practice that is ubiquitous in medicine but little-known outside of it. The NFL case exposes how a widely-accepted statistical practice is rooted in beliefs about the physical and mental inferiority of Black men, women, and trans individuals compared to whites and is accepted by the medical community. Whether grounded in genetics, culture, or social conditions, arguments that cognition, lung capacity, kidney function, or any other biological function vary in an unchanging way by “race” or “demographic groups” essentialize further the idea that “race” is a fixed entity. Race correction reveals the worst of racial science and if the NFL truly believes, as it says, that Black lives matter, it must stop race correction in the concussion settlement.
Lucia Trimbur is Associate Professor in the Department of Sociology and Program in American Studies at the City University of New York, and the author of Come Out Swinging: The Changing World of Boxing in Gleason’s Gym. Lundy Braun is Professor in the Departments of Africana Studies and Pathology & Laboratory Medicine at Brown University, and the author of Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics.