Traumatic Brain Injury in the United States:
A Report to Congress

Introduction

Public Health Significance of Traumatic Brain Injury

Traumatic brain injury is a leading cause of death and lifelong disability among children and young adults in the United States. The Centers for Disease Control and Prevention (CDC) has estimated that each year, approximately 1.5 million Americans survive a traumatic brain injury,1 among whom approximately 230,000 are hospitalized.2 Approximately 50,000 Americans die each year following traumatic brain injury, representing one third of all injury-related deaths.3 Adolescents, young adults, and the elderly are at highest risk of these injuries; the most common causes are attributed to motor vehicle crashes, falls, and violence.

One study estimated that the annual economic burden of TBI in the United States was approximately $37.8 billion in 1985.5 This estimate included $4.5 billion in direct expenditures for hospital care, extended care, and other medical care and services; $20.6 billion in injury-related work loss and disability; and $12.7 billion in lost income from premature death. This study could not account for the intangible costs borne by the families and friends of individuals who die prematurely from brain injury. For injured persons and their loved ones, the physical and emotional tolls from permanent disability are profound and impossible to quantify.

Thus, traumatic brain injuries have a deep impact on the population and require a response from the public health community to prevent these injuries and reduce consequent disabilities. To achieve this goal, the Division of Acute Care, Rehabilitation Research, and Disability Prevention in CDC's National Center for Injury Prevention and Control (NCIPC) has been working since 1989 to develop a traumatic brain injury surveillance system that provides representative data regarding the incidence, risk factors, and causes of traumatic brain injury in the United States and allows comparisons across jurisdictions. The system supports the development, implementation, and evaluation of programs for preventing traumatic brain injury. This effort is enabled, in part, by funding under Public Law 104-166, the Traumatic Brain Injury Act of 1996.

What the Traumatic Brain Injury Act of 1996 Mandates

Public Law 104-166 charges CDC with implementing projects to reduce the incidence of traumatic brain injury. Specifically, the legislation mandates that CDC shall:

Develop a uniform reporting system for traumatic brain injuries.

Conduct research into the identification of effective strategies for preventing traumatic brain injury. Implement public information and education programs for preventing TBI and for broadening public awareness about the public health consequences of TBI.

Provide technical assistance, either directly or through grants and contracts, to public or nonprofit entities for planning, developing, and operating projects to reduce the incidence of traumatic brain injury.

Present a report to Congress that describes the incidence and prevalence of traumatic brain injury. Funding for all these activities was authorized at $3 million for each of the fiscal years 1997, 1998, and 1999.

Executive Summary
Introduction
CDC's Traumatic Brain Injury Surveillance Program, 1989-1998
Current Data on Traumatic Brain Injury Mortality and Morbidity
CDC Estimates of Traumatic Brain Injury-Related Disability
Public Health Goals
References
Appendix: Methods Used to Produce Estimates for This Report