Each year, about 1.5 million Americans sustain a traumatic brain injury (TBI). That's 8 times the number of people diagnosed with breast cancer and 34 times the number of new cases of HIV/AIDS each year.

• An estimated 5.3 million Americans?2% of the U.S. population? currently live with disabilities resulting from TBI.
  
• Among children and young adults, TBI is the type of injury most often associated with deaths from unintentional injuries.
  
• Estimated TBI rates for African American children ages 0 to 4 are about 40% higher than those for white children.
  
• Approximately 1 in 4 adults with TBI is unable to return to work one year after injury.
  
• TBIs requiring hospitalization cost the nation about $56.3 billion each year. Included in this cost are decreased tax revenues and increased welfare costs that result when injured persons or their caregivers are unable to return to work.
  
  
  

Congressional funding began with the TBI Act of 1996. Since then, CDC has supported data collection and follow-up studies in selected states to track and monitor TBI, to link people with TBI to information about access to services, and to find ways to prevent TBI-related disabilities.

States' surveillance yields valuable data

For several years, CDC has funded 15 states to track and monitor traumatic brain injuries. The Center's researchers will soon publish a review of TBI deaths for 1989?1998 and an update on TBI hospitali-zations for 1996?1997. Data in these reports will inform decisions about TBI prevention efforts and provision of services for brain injured persons.

Data lead to increased funding

TBI data from CDC-funded surveillance inform policy, increase prevention efforts, and improve the lives of people with TBI. South Carolina used its data to demonstrate a need to increase services for people with TBI. After seeing estimates of the number of state residents who will likely experience TBI-related disabilities, decision makers significantly increased the budget for TBI services. South Carolina's FY 2001 budget included more than $9 million to be used for a variety of TBI and spinal cord injury services?that's a 900% increase over the 1995 budget for such services.

Guiding research about TBI among children and youth

TBI is described as the leading cause of disability among children, but evidence to support this assertion is lacking. In October 2000, the Injury Center sponsored a meeting of injury researchers, professionals and advocates to discuss methods for better assessing outcomes of TBI in children and youth. The meeting report, which summarizes participants' recommendations for further research in this area, was released in May 2001. CDC will soon fund a study to find out how many children have TBI-related disabilities and how those disabilities affect them and their families. The study will build upon the recommendations generated at the October 2000 meeting.

Brochure helps families

In 1999, CDC published Facts About Concussion and Brain Injury, a brochure addressing the needs of people with less severe TBI and the needs of their families and caregivers. Hospital emergency department staff, other health care providers, and community organizations have used the brochure to help explain what can happen after a mild brain injury (or concussion), how to get better and where to go for help. CDC recently translated the brochure into Spanish and tested the translation with focus groups. The Spanish version will be published in early 2002.

Revisions to surveillance guidelines underway

CDC's Guidelines for the Surveillance of Central Nervous System Injury, published in 1995, established standards for collecting data on traumatic brain and spinal cord injury. These standards have been used throughout the U.S. and abroad. CDC is currently revising the guidelines to incorporate improved methods for TBI surveillance.

The revision will be published in early 2002.

CDC-funded researchers address prevention, outcomes, and service provision
CDC funds TBI research in several academic institutions. Results of these projects will guide development of programs to prevent TBI and the secondary conditions associated with it as well as programs to link persons with TBI with needed services.

• The University of Pittsburgh is working to incorporate the "Think First for Kids" program in at least 50% of the city's elementary schools. The program teaches children about preventing traumatic brain and spinal cord injury through lessons about violence prevention and motor vehicle, bicycle, playground and water safety. Researchers will evaluate both the process and outcome of the program's implementation.
  
• Baylor College of Medicine in Houston investigated depression among people with a mild to moderate TBI. They found that 20% of patients developed depression within 3 to 6 months after injury. This is twice the frequency of depression found among patients who sustained trauma that did not involve the brain. Almost 40% of TBI patients in this study had at least one of the following secondary conditions within 3 to 6 months after injury: depression, post concussive disorder, or post traumatic stress disorder.
• Colorado State University and the University of South Carolina are researching ways to link people with TBI to information that can help them get the services they need. Preliminary findings released in 2000 indicate that 1 in 3 people with reported disability received no services after discharge from the hospital. The findings of these projects will shape recommendations for state policies to improve access to available services.
  
  
  

Future Steps

Brain injuries are a major problem with devastating consequences to both injured individuals and society at large. The impact of TBI in the U.S. indicates a need for ongoing monitoring and dedicated prevention efforts. In response to the TBI Act Reauthorization, part of the Children's Health Act of 2000, CDC is moving forward in the following areas:

TBI in children

CDC has investigated the best methods for obtaining information about TBI outcomes in children and is funding research to improve these methods. CDC will soon fund a registry/follow-up study in one state to learn more about what happens to children after a TBI.

"Mild" TBI

By April 2002, CDC will report to Congress about methods for identifying people with TBI, including those who do not receive medical care. Injury Center scientists have completed a literature review of 500 articles about mild TBI, and they are currently preparing a methods document to be used to generate discussion about the issue. In September 2001, they convened a panel of experts to make recommendations for addressing the issue of identifying people with mild TBI.

Education and awareness

In addition to publishing a Spanish version of its brochure Facts About Concussion and Brain Injury (discussed previously), CDC is working closely with the National Brain Injury Association to develop new public education, media, and training materials.

(Source: http://www.cdc.gov/ncipc/fact_book/29_Traumatic_Brain_Injury.htm)