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McDonogh high school football lineman Jordan McNair watches from the sideline during a game Sept. 16, 2016, in McDonogh, Md.

Football was designed to emphasize both teamwork and violence, while being an embodiment of the national character.

But as more has become known about the extent of the violence wreaked, efforts have been made on levels from Pop Warner football to the National Football League to limit immediate and long-term injuries as well as fatalities.

As historian Taylor Branch has written, football emerged in the late 19th century after the railroads opened up the frontier and American leaders were concerned the nation was getting soft.

College students, though, embraced a violent variation of rugby, pitting 15 players on each side, moving the ball forward until a tackled player yelled “down.”

Yale graduate Walter Camp re-invented the game, limiting sides to 11, drawing lines on the field, restarting plays at a line of scrimmage, allowing four “downs” to make 10 yards and naming positions.

Violence, though, was paramount. One newspaper cited 25 deaths in a year and bare-knuckled heavyweight champion John L. Sullivan preferred the ring to football because “there’s murder in that game.”

When the Harvard faculty sought to abolish football in 1895, Chief Justice Oliver Wendell Holmes, an alumnus, said casualties were “not as a waste, but as a price well paid for the breeding of a race fit for leadership and command.”

President Theodore Roosevelt, though, convened a meeting of coaches to promote safety, including the forward pass to spread the field.

Fast forward to President Donald Trump who derided the National Football League for embracing safety measures after revelations about chronic traumatic encephalopathy brain disease.

“Uh-oh, got a little ding on the head? No, no, you can’t play for the rest of the season!” remarked Trump, whose military service was sidelined by debilitating bones spurs.

Before the season kicked off this year, University of Maryland lineman Jordan McNair collapsed in searing heat and died at an August practice. The university admitted blame when a tub of ice water could have saved his life. The strength and conditioning coach was fired.

A few weeks later in Crowley, Texas, middle-schooler Kyrell McBride-Johnson, 13, died at a practice after signaling for water.

USA TODAY noted that 13 high school players died last year from incidents involving heat stroke, head injuries and sudden cardiac arrest.

Unfortunately, when it comes to implementing procedures to curtail fatalities on the gridiron and other sports, Iowa high schools are lagging far behind, according to a new national survey.

The Korey Stringer Institute at the University of Connecticut — named after the Minnesota Vikings All-Pro lineman who died from exertional heat stroke following an August 2001 practice — ranked all 50 states and the District of Columbia for implementation of “best practice” sports safety measures, which were established by sports-related medical groups, athletic trainers, the National Federation of State High School Associations and the National Interscholastic Athletic Administrators Association.

New Jersey was No. 1, implementing 79.3 percent of the recommendations.

Iowa was No. 46 with 37 percent, ahead of Wyoming, New Hampshire, Montana, California and Colorado.

Among the recommendations, which include sports other than football (notably contact sports such as hockey and soccer), are:

  • Having athletic trainers at practices and competitions.
  • Acclimating athletes progressively to training demands and environmental conditions.
  • Providing athletic trainers with the tools to assess suspected concussions.
  • Conducting annual brain and spine safety education for all student-athletes.
  • Having a comprehensive medical-management plan for acute care of potential cervical or brain injuries.
  • Providing large hydration stations.
  • Limiting body mass weight loss to 2 percent in any session.
  • Having a cold-water immersion tank ($150 cost) or other cold-water immersion to deal with overheated athletes before emergency services personnel arrive.
  • Having athletes undergo cardiovascular screening.
  • Having a defibrillator onsite — with school staff, medical professionals, coaches and athletes aware of its location and usage.
  • The National Federation of State High School Associations was defensive about the rankings, citing:
  • Statistics that the number of high school athletes dying from heat-related causes drop
  • ped from 22 in 2008-12 to eight the past five years.
  • That it provided more than 400 defibrillators to schools and state associations, with the goal of one in every high school.
  • That it also provided “Anyone Can Save a Life” emergency action plan tool kits to every high school.
  • Lowering the sports fatality rate to “zero,” it maintains, “isn’t realistic” with 1.1 million students playing football and eight million students engaged in all sports at 19,500 schools.

No, it isn’t. But to quote Melania Trump, “Be better.” The failure of 29 states, including Iowa, to implement 50 percent of the “best practice” recommendations, is unacceptable. (California, for one, blames a lack of athletic trainers.)

Colleges must do better, too, particularly after having sold out to TV networks to offer more football games, pushing training into unbearable early August heat. Fatalities like Jordan McNair are inexcusable.

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