Public health approach to reducing traumatic brain injury: Update from CDC

Ongoing efforts by the Centers for Disease Control and Prevention (CDC) to reduce the population impact of traumatic brain injury (TBI) are documented in the May/June issue of The Journal of Head Trauma Rehabilitation, official journal of the Brain Injury Association of America.

"This special issue draws attention to the need for strategies to prevent TBI and to lessen the substantial physical, psychological, economic, and social effects among people who experience it," write co-editors Jeneita M. Bell, MD, MPH and Christopher A. Taylor, PhD of CDC's National Center for Injury Prevention and Control. CDC is tasked with working to reduce the incidence of TBI by the federal Traumatic Brain Injury Act, passed by Congress in 1996 and renewed multiple times since.

New Research toward Reducing the Burden of TBICDC's strategic plan for TBI aims to achieve the greatest possible reductions in deaths and negative health effects of all TBIs, including concussions. The four pillars of CDC's strategic plan for TBI are:

(1) improving the understanding of the public health burden of TBI, (2) reducing the incidence of TBI through primary prevention, (3) improving recognition and management of mild TBI (i.e., concussion), and (4) promoting healthy lifestyles and improving health outcomes for people living with TBI.

The special issue highlights new research focusing on this public health approach to TBI. Topics include:

• A new data source (the Healthcare Cost and Utilization Project [HCUP]) that improves TBI monitoring nationwide. The large size of the HCUP databases will aid in understanding TBI's impact in population subgroups.
• The problem of unemployment after TBI. New data show that 60 percent of patients who received inpatient rehabilitation for TBI are still unemployed two years after discharge.
• Motorcycle crashes as a cause of TBI. People injured in motorcycle crashes use more healthcare resources and are three times more likely to die in the emergency department, compared to those with other causes of TBI.
• The high impact of sports—and recreation-related TBIs. About seven percent of all emergency department visits for sports—and recreation-related injuries are TBIs, with at least 3.4 million sports—and recreation-related TBI emergency department visits occurring over a 12-year study period.
• The effectiveness of CDC's HEADS UP new online course. This course—part of CDC's HEADS UP educational campaign—aims to improve recognition and management of concussion in sports. Results suggest that the course increases concussion-related knowledge among coaches and others involved a wide range of sports.

CDC has partnered with the traumatic brain injury and rehabilitation communities in order to implement a broader public health approach to TBI—especially in mitigating the severity of TBI and reducing its impact on quality of life. "JHTR is pleased to again provide a forum for the dissemination of scholarly works from our colleagues at CDC," comments John D. Corrigan, PhD, ABPP, Editor-in-Chief of The Journal of Head Trauma Rehabilitation. "The Editors applaud their emphasis on translating what we know about TBI into measures to decrease the burden of injury on individuals, families, and society."