Runner’s death at New York City Marathon draws attention to rare race risks

Rachel Apa had little more than three kilometres left in the New York City Marathon when she collapsed on Sunday. The 24-year-old was taken to hospital after attempts to revive her at the course, but died that night, her parents told the New York Times. A record 61,146 runners finished the race.

Apa collapsed near mile 24, about 38.6 kilometres into the 42.2-kilometre event. Race organizer New York Road Runners said a bystander performed CPR before event medical staff continued treatment. A defibrillator was also used before paramedics took her to Mount Sinai Hospital, according to The Associated Press. She arrived in critical condition, and doctors spent several hours trying to save her.

Her father, Steve Apa, said the cause of death was rhabdomyolysis, a serious condition in which muscle cells break down and release their contents into the bloodstream. Severe physical exertion can trigger the condition. He told USA Today that Rachel, a lifelong athlete and former Division I field hockey player at Bucknell University, had prepared carefully for months. Although this was her first marathon, he said, “She did everything she's supposed to.”

Deaths during distance races remain uncommon, experts told CBC News. Jack Goodman, a University of Toronto professor emeritus in kinesiology and adjunct cardiovascular research scientist at University Health Network, said marathons have not become riskier over the past two decades. Instead, their growing popularity means rare emergencies occur within a much larger population of participants. Montreal cardiologist and epidemiologist Dr. Christopher Labos said the unexpected nature of these deaths also attracts considerable news coverage.

Participation figures illustrate that growth. A record 1.3 million people have applied for the 2027 London Marathon, while demand for Boston Marathon places has prompted tighter qualifying times. A 2025 study in the Journal of the American Medical Association reported that more than 29 million people completed American marathons and half-marathons between 2010 and 2023, three times the number recorded a decade earlier.

A 2019 global review published in the BMJ put the overall death risk at roughly one in 150,000 runners. It found that deaths were more common among men, frequently involved coronary artery disease and occurred most often in the final quarter of a race. The 2025 American study found that the risk of dying from a cardiac event during long-distance races had fallen by about half in recent years, likely reflecting better emergency preparations and access to defibrillators.

The American researchers also observed a small increase in non-fatal cardiac events since 2020. They suggested that reduced access to health care during the COVID-19 pandemic might have left more cardiovascular disease undetected. Goodman said fatal cardiac events often involve coronary disease that runners did not know they had.

Apa worked as an industrial-technology product manager and ran to raise money for Parkinson’s disease in honour of her grandfather, whom she described on her fundraising page as her “role model.” By Tuesday evening, the campaign had collected more than $26,000 US.