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
- An estimated 5.3 million Americans?2% of the
U.S. population? currently live with disabilities resulting from
- Among children and young adults, TBI is the type
of injury most often associated with deaths from unintentional
- 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
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
The revision will be published in early 2002.
CDC-funded researchers address prevention, outcomes, and
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
- 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
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
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.