Shortly after I learned that the New England Patriots and the Philadelphia Eagles were to face off in Super Bowl LII, I found an illustration depicting “Death” as a skeleton while doing some research online. Death stands at the edge of a football field littered with bodies, holding a pigskin against the ground with one bony hand. The image accompanied an old story published in The New Yorker about football and the sport’s capacity for injuring players. The caption labeled Death as “The Twelfth Player in Every Football Game.”

The illustration’s morbid message may reflect a concern about findings showing that some hits sustained by football players can, in the long term, contribute to mortal injuries. A small but key study that examined the brains of a group of professional and nonprofessional football players found that a majority of them showed signs of a brain disease called chronic encephalopathy (CTE), which scientists have noted in some high school players.

Researchers published these results in the Journal of the American Medical Association. But additional findings about the condition and its link to sports-related head trauma have also been published in other authoritative scientific journals and support a reason to worry.

According to reports, for the past few years, there’s been a marked decline in high school kids’ participation in football.

Although the causes of the downturn are unconfirmed, many believe that worries about head injuries voiced by the medical community contributed to the slump. If the trend continues, some wonder how this might affect the pool of talent from which professional football selects its most promising young players.

The evidence of degenerative disease found in the brains of significant numbers of athletes involved in rock-’em-sock-’em sports prompted folks like Jeff Miller, the National Football League’s top health and safety official, to affirm a link between football-related concussions and CTE.

Those who want to preserve the game—whether for revenue or recreation—suggest that sports leagues and programs follow the lead of the Pop Warner football program, the country’s largest youth football organization, and focus on safety for players in comprehensive ways. (Pop Warner bans kickoffs, punts and head-on blocking and prescribes more training for coaches.)

According to sports injury statistics from the Johns Hopkins Health Library, more than 3.5 million children ages 14 and younger get hurt annually playing sports or participating in recreational activities. The highest rates of injury occur in sports that involve contact and collisions, and most injuries in organized sports occur during practice.

The stats also show that football consistently accounts for the largest number of catastrophic injuries as compared with other high school sports. Surely, this fact, combined with the tragic life-changing effects of such injuries, should stay on the brains of school officials, parents and folks in the NFL.