Statistical data on the incidence of TBI has been collected by the 50 individual states, and by various agencies of the federal government, including the CDC (Centers for Disease Control). A new TBI occurs every 15 seconds in this country. The median rate of annual TBIs across the country is 200 per every 100,000 persons, with individual variations by state and county. In the mid 1980s there were 2,000,000 new TBIs every year in the USA with 65,000 to 75,000 deaths and 500,000 hospitalizations.
As of the late 1990s the national incidence rate dropped to 1.5 million new cases of TBI each year. These were associated with 50,000 deaths; 230,000 hospitalizations; 2,000 people in a permanent vegetative state; 5,000 people with seizure disorder; and 70,000 to 90,000 people living with significant long term or permanent disability. TBI is the leading killer and disabler of persons aged 1-44. The most hard hit group is males aged 15-24 (often from mixing alcohol with driving), followed by children (due to bicycle accidents and child abuse) and persons aged 75 plus (due to falls). Males are twice as likely to sustain a TBI as females. Half of all TBIs come from motor vehicle accidents, with the remainder due to firearms violence (20%), falls, bicycle accidents, contact sports injury and other assorted causes.
Alcohol is associated with about half of all these incidents. Programs to curb drunk driving; programs to keep fatigued truck drivers off the highways; programs to increase helmet use by motorcycle riders and bicycle riders; programs to increase wearing of seatbelts in cars; developments of air bags; improved seat and headrest design; and longer “crumple zones” for head-on car collisions; have all contributed to a decrease in incidence of TBI.
In 1990 a neurologist named Goldstein published a now famous editorial in Annals of Neurology 27:327 calling Traumatic Brain Injury a “silent epidemic” due to a deafening lack of public attention and government funding of research and prevention efforts. Thanks to the concentrated efforts of the national brain injury association (www.bia.usa.org) and a host of individuals (including patient advocates, neurologists like James P. Kelly of Chicago, neurosurgeons like Randall Chestnut and others) we have come a long way.
Two milestones were the enactment of the federal Traumatic Brain Injury Act in 1996, and the holding of the first ever National Institutes of Health consensus conference on Rehabilitation of Persons with TBI in Bethesda, Maryland during October 1998. As we move into a brand new century, we hope to sustain, and even increase, the momentum for new prevention efforts and increased spending on research, treatment, rehabilitation and cure.