A runner died in the New York City Marathon. Have the risks changed as more people race?
Every year, amid our current running boom, more and more people vie for the chance to lace up their sneakers and push themselves 42.2 kilometres to cross that finish line. But every year, young and seemingly healthy people also die trying.
Rachel Apa, 24, died after collapsing just over 3 km from the finish line
Natalie Stechyson · CBC News
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She was just a few kilometres from the finish line.
A record-breaking 61,146 runners completed the New York City Marathon on Sunday. But Rachel Apa, despite being in what her father describes as perfect health, wasn't one of them.
The 24-year-old athlete collapsed near mile 24, or about 38.6 kilometres into the 42.2-kilometre race. Despite the life-saving efforts of bystanders, paramedics and then hospital doctors, she was pronounced dead later that night, her grieving parents told the New York Times.
"It's unfathomable," her father Steve Apa, who could not be reached by CBC News, told the news outlet.
Every year, more and more people vie for the chance to lace up their sneakers and push themselves 42.2 kilometres to cross that finish line. But every year, young and seemingly healthy people also die trying — typically of heart failure or cardiac arrest.
All told, including Rachel Apa, at least six runners have died racing in marathons and half-marathons around the world in the past six months alone. Still, experts say the incidence rate is very low, given that millions of people run them every year.
Marathons aren't any riskier than they were 20 years ago, but they are far more popular, explained Jack Goodman, a professor emeritus in kinesiology at the University of Toronto, and adjunct scientist of cardiovascular research at Toronto's University Health Network.
"When the population is so large, there are bound to be more cases, rare as they are," Goodman told CBC News.
Any time you have thousands of people in the same space, based on probabilities, one of them will have a cardiac event, Dr. Christopher Labos, a cardiologist and epidemiologist in Montreal, told CBC News.
"You just hear about it more in the news because it's so shocking when something unexpected like this happens."
Rachel Apa is pictured in the 2023 field hockey roster on the athletics website for Bucknell University in Lewisburg, Pa. (Bucknellbison.com)
Risk of dying has decreased: study
Anyone who has tried to register for a marathon in the last few years can tell you how popular they've become. A record 1.3 million people have already applied to run the 2027 London Marathon. So many people have tried to register for the Boston Marathon in recent years that they've tightened their qualifying times.
In the U.S. alone, more than 29 million people completed marathons and half-marathons in between 2010 and 2023, notes a 2025 study published the Journal of the American Medical Association (JAMA). That's triple the number compared to a decade earlier, the authors add.
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Overall, the risk of risk of death is about one in 150,000 runners, notes a 2019 global review in the BMJ medical journal. Typically, the risk is much higher for men, the cause is often coronary artery disease and the deaths most often occur in the last quarter of the race, the study says.
"There are infrequent deaths, which are often reported widely, and may create unnecessary alarm about the potential risks," the authors wrote.
The 2025 JAMA study points out that the risk of dying from a cardiac event during long-distance running races in the U.S. has actually gone down by about 50 per cent in recent years — likely due to more effective emergency planning, including access to defibrillators.
But the study also noted a small uptick in non-fatal cardiac events since 2020, which the authors hypothesized could be due to less access to health care during the COVID-19 pandemic, leading to reduced detection of cardiovascular disease.
Runners make their way through Queens during the New York City Marathon Sunday. (Heather Khalifa/The Associated Press)
Usually a pre-existing cause, expert says
Most often, in the case of death, there's underlying coronary disease the runner didn't know about and never caused them a problem until the race, said Goodman.
"Sudden cardiac death is, unfortunately, not a terribly uncommon first symptom of heart disease," he said.
Just last month, 24-year-old Treyton Lara collapsed at mile 20 of the Portland Marathon and died. He'd experienced a sudden cardiac arrest, his family said. In January, Julien Autissier, 33, collapsed around the 19-mile mark of the Miami marathon and died in the hospital. Doctors also suspected sudden cardiac arrest, according to the Miami New Times.
Roland Liinar, 25, died last May after collapsing in the Rimi Riga Marathon in Latvia. The same month, two other runners died after collapsing while competing in half-marathons in New York and the U.K.
Still, from a public health perspective, the problem most people have is moving too little, not moving too much, said Lagos, the cardiologist and epidemiologist. And if you're a young healthy person who trained properly for a marathon, a cardiac event is "almost certainly not going to happen in your case."
Runners cross the finish line in Central Park on Sunday. (Angelina Katsanis/The Associated Press)
'She did everything she's supposed to'
Apa, an industrial-technology product manager, had run to raise money for Parkinson's disease in honour of her grandfather. On her fundraiser page, which had raised more than $26,000 US by Tuesday evening, Apa called him her "role model."
New York Road Runners, the non-profit club that stages the New York City Marathon, said in a news release that CPR was administered to Apa by a bystander and later by event medical staff. A defibrillator was also used before paramedics took Apa to the Mount Sinai Hospital, reports The Associated Press.
The former Division I field hockey player at Bucknell University was in critical condition when she was brought to the hospital, where doctors unsuccessfully tried to save her for several hours.
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Steve Apa says Rachel's cause of death Sunday was rhabdomyolysis, a rare but serious condition where the muscle cells break down and leak into the bloodstream. Rhabdo, as it is often called, can be brought on by severe physical exertion.
Exercise-induced rhabdo cases aren't tracked across Canada, CBC News has previously reported. But there was recently a spike of cases in young women in St. John's, with health officials pointing to intense workouts and social media competitiveness.
It was her first marathon, but Rachel was a lifelong athlete, her father told USA Today, and she had trained carefully for months.
"She did everything she's supposed to."
WATCH | What is rhabdomyolysis?:
Dangerous fitness: What is rhabdomyolysis?
April 11|
Duration
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Rhabdomyolysis is a condition that can happen after an intense workout and can be life-threatening if left untreated.ABOUT THE AUTHOR
Natalie Stechyson has been a writer and editor at CBC News since 2021. She covers stories on social trends, families, gender, human interest, as well as general news. She's worked as a journalist since 2009, with stints at the Globe and Mail and Postmedia News, among others. Before joining CBC News, she was the parents editor at HuffPost Canada, where she won a silver Canadian Online Publishing Award for her work on pregnancy loss. You can reach her at natalie.stechyson@cbc.ca.
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