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Traumatic Brain Injury in the United States: A Public Health Perspective

Thurman, David J. MD, MPH*; Alverson, Clinton MS; Dunn, Kathleen A. MD, MSPH*; Guerrero, Janet MS; Sniezek, Joseph E. MD, MPH*

Journal of Head Trauma Rehabilitation: December 1999 - Volume 14 - Issue 6 - p 602–615
Special Article

Traumatic brain injury (TBI) is a leading cause of death and disability among persons in the United States. Each year, an estimated 1.5 million Americans sustain a TBI. As a result of these injuries, 50,000 people die, 230,000 people are hospitalized and survive, and an estimated 80,000–90,000 people experience the onset of long-term disability. Rates of TBI-related hospitalization have declined nearly 50% since 1980, a phenomenon that may be attributed, in part, to successes in injury prevention and also to changes in hospital admission practices that shift the care of persons with less severe TBI from inpatient to outpatient settings. The magnitude of TBI in the United States requires public health measures to prevent these injuries and to improve their consequences. State surveillance systems can provide reliable data on injury causes and risk factors, identify trends in TBI incidence, enable the development of cause-specific prevention strategies focused on populations at greatest risk, and monitor the effectiveness of such programs. State follow-up registries, built on surveillance systems, can provide more information regarding the frequency and nature of disabilities associated with TBI. This information can help states and communities to design, implement, and evaluate cost-effective programs for people living with TBI and for their families, addressing acute care, rehabilitation, and vocational, school, and community support.

National Center for Injury, Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Thurman) (Alverson) (Dunn) (Guerrero) (Sniezek)

Address Correspondence to David J. Thurman, MD, MPH, CDC National Center for Injury Prevention and Control, 4770 Buford Highway, NE, Mailstop F41, Atlanta, GA 30341–3724, email

*Medical Epidemiologist


Medical Statistician.

I.E. Sniezek is currently affiliated with the National Center for Chronic Disease Prevention and Health Promotion.

The authors wish to acknowledge the contributions of the following people in the preparation of this report: Doug Browne, Renee Johnson, Valerie Johnson, and Jean Langlois, CDC National Center for Injury Prevention and Control; Susan Toal, Contractor; Pam Gosler, Arizona Department of Health; Barbara Gabella and Richard Hoffman, Colorado Department of Public Health and Environment; Gail Whiteneck, Craig Hospital, Denver, Colorado; Mark Kinde and Jon Roesler, Minnesota Department of Health; Garland Land and Mark van Tuinen, Missouri Department of Health; Loretta Santilli, Kathleen Thoburn, and Gerald Feck, New York State Department of Health; Pam Archer, Michael Crutcher, and Sue Mallonee, Oklahoma State Department of Health; Ernest McCutcheon and Anbesaw W. Selassie, University of South Carolina School of Medicine; Leroy Frazier, South Carolina Department of Health and Environmental Control.

© 1999 Lippincott Williams & Wilkins, Inc.