| EPIDEMIOLOGY
OF A BRAIN INJURY [ back
to Brain Injury 101 ]
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.
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