August is the time when schools across the country start official football practices. Parents and coaches will pray that no player drops dead from heat exhaustion. It's a rare event, and rule changes and precautions have been made, which is goo. But truth be told, parents need to hold their breath through every play of the season, as American-style football — by its design and the way it is played — has high risk of injury to our youth.

Football, from the first kickoff to the final whistle, involves bone-breaking, ligament-twisting, and head-knocking action. Players on both sides line up head-to-head. Defensemen often tackle using their heads, and the ball carriers, as last-ditch efforts, buck with their heads to avoid a tackle or gain an extra yard.

All sport has some degree of risk for bodily injury; however, the nature and extent of bodily harm due to youths playing football is perverse.

In 2013 the Institute of Medicine and the National Research Council released a report from an expert committee reviewing the science of sports-related concussions in youth. While the committee pointed out the lack of highly reliable or centralized data concerning the overall incidence of sports-related concussions among youths, there were enough reports reviewed that showed concussions were on the rise and football was a leading cause.

According to the Centers for Disease Control and Prevention, roughly 2.7 million youths under 20 were treated for sports and recreation injuries from 2001 to 2006. During this same period, emergency room visits for traumatic brain injuries among children under 19 rose 62 percent.

Because of the risks involved, board members and officials of elementary and high schools should seriously consider not sponsoring football for its students. No question this is a radical idea and would be a major social and economic change for schools and communities.

Football at all levels of play is unequivocally part of the American cultural pastime. We invest a lot of time, attention, emotion, and money into the game. Most can relate to the exuberance that winning football teams bring to players and those who watch. Many have had a Remember the Titans experience, recalling the 2000 film about a Virginia high school team. And less-than-stellar players can dream about being the next Rudy, the star of another gridiron film. Our most red, white, and blue-blooded holiday, Thanksgiving, is spiced up with football. So calling for the removal of football in schools will most likely be viewed as un-American.

At a time when we are fighting against our children becoming overweight and wanting them to get more exercise, why pull the plug on a youth sport that many of them play? At a time when "grit" is identified as a healthy characteristic for college and workplace success, why pull the sport off the list of options?

Maybe it is time to think of football, especially at the scholastic level, not only with such terms of endearment. Maybe it is time to think about scholastic football in terms of what benefits and risks it provides our youth on balance and in the long run.

It may not be well known, but the American Public Health Association, along with several major medical associations, called for a ban on boxing, at all levels of play, as early as 1985. In its policy statement, the association said boxing is inherently dangerous and, by design, puts players at risk of harm. Second, it said that the litany of rule changes, equipment tweaking, and "better surveillance of harm" by apologists to reform the sport would lessen but not substantially eliminate the injury problems. Third, there are ample alternatives for any benefits that boxing provides.

These same arguments can be applied to American-style football. While progress has been made by coaching players not to use their heads directly in a play, the fact is the head is almost always in harm's way; there is no rule change that can make the head incidental.

We should question why we expend so much time, money, and energy on an enterprise that invariably sacrifices so many young minds, bodies, and sometimes spirits. It is time for school leaders and parents to seriously consider getting our children off the gridiron.

Stephen F. Gambescia is professor of health services administration at Drexel University. sfg23@drexel.edu