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CDC Traumatic Brain Injury Activities Angela Marr, MPH May 13, 2004 National Center for Injury Prevention and Control Centers for Disease Control and Prevention.

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Presentation on theme: "CDC Traumatic Brain Injury Activities Angela Marr, MPH May 13, 2004 National Center for Injury Prevention and Control Centers for Disease Control and Prevention."— Presentation transcript:

1 CDC Traumatic Brain Injury Activities Angela Marr, MPH May 13, 2004 National Center for Injury Prevention and Control Centers for Disease Control and Prevention

2 CDC Mission To promote health and quality of life by preventing and controlling disease, injury, and disability.

3 Traumatic Brain Injury (TBI) is: A blow or jolt to the head resulting in disruption of the normal function of the brain.

4 TBI Problem Impact and Magnitude of TBI in the United States: 1.5 million people sustain a TBI annually At least 5.3 million people live with disabilities resulting from TBI

5 Background TBI Act of 1996 The Children’s Health Act of 2000 CDC receives $ 4 million for TBI Among other responsibilities, CDC assigned to: Collect and disseminate information on incidence of TBI and prevalence of TBI-related disability Develop an education and awareness campaign

6 Background CDC’s unique role in TBI Provides population-based information about the importance of TBI as a public health problem at the national and state level.

7 Overview of TBI Activities Analysis of national TBI data State programs Injury Core Capacity Building Injury indicators report TBI surveillance TBI follow-up TBI linkage projects Education and awareness

8 Analysis of National TBI Data

9 National Data Analysis Critical to understanding the impact of TBI on public health Provides a comparison point for states Provides useful information for legislators and policy makers

10 Data Sources The National Hospital Ambulatory Medical Care Survey (NHAMCS) The National Hospital Discharge Survey (NHDS) The Multiple Cause of Death data (MCOD)

11 ??? Visiting Private Doctor or Receiving no Medical Care 1,000,000 Emergency Department Visits 53,000 Deaths 230,000 Hospitalizations Overview of TBI in the United States Source: MCOD ( ), NHDS ( ), NHAMCS ( )

12 Average Annual Rates of TBI-related Deaths, Hospitalizations, and ED Visits, by Age, United States, Source: MCOD ( ), NHDS ( ), NHAMCS ( )

13 State Programs

14 Injury core capacity Injury indicators report TBI surveillance TBI follow-up TBI service linkage projects

15 Core State Injury Programs Core State Injury Programs were designed to build injury prevention and control capacity at the state level. Allows states to tailor to their state’s injury problems. States have better access to communities and local organizations.

16 Core State Injury Activities Establish a focal point for injury prevention activities Form injury advisory councils Use data Conduct resource assessment Develop state injury plan

17 Core Data Sources VR -Vital Records HDD -Hospital Discharge Data FARS -Fatality Analysis Reporting System ED -Emergency Department ME - Medical Examiner/Coroner Data CDR -Child Death Review Team Data UCR - Uniform Crime Reporting System EMS -Emergency Medical Services Data OPU -National Occupational Protection Use Survey Data BRFSS/YRBSS - Behavioral/Youth Risk Surveillance System

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19 Injury Indicators Report CDC provides guidance to states to analyze their own injury data of which TBI is an indicator Includes: 1999 data (2 nd Edition) 26 states chose to participate

20 State Injury Indicators Report Goal Improve state- based injury surveillance to better support injury prevention programs and policies.

21 State Injury Indicators Report CDC/NCIPC Disseminates instructions for indicator calculation Coordinates data submission Writes text sections Prepares and distributes the document States Participate in the dialogue and add knowledge Calculate and submit data in a standardized way Use data to affect state and local public health

22 State Injury Indicators Report, Version 2 Delaware

23 TBI Multi-state Surveillance Maintain TBI surveillance in 12 states All 12 collect basic data 6 also abstract medical records 2 conduct ED surveillance

24 Surveillance is: The systematic and ongoing collection of data

25 Types of Data Collected Demographic Cause of injury Severity and early outcome data Additional circumstances of injury information

26 Data Sources Hospitalizations Hospital Discharge Data Trauma Registry Data TBI Registries Medical Records Deaths Multiple Cause of Death Edited Unedited

27 TBI Multi-state Surveillance Product Linked hospitalization and death data Estimate incidence of TBI Describe the population at risk Identify causes of injury Inform policy development

28 TBI Surveillance Programs TBI Surveillance State Extended TBI ED Surveillance

29 Examples of the Multi-state TBI Surveillance Results

30 Age-adjusted TBI-related hospital discharge rates, by state MMWR Langlois, et al

31 TBI-related hospital discharge rates, by age and sex states

32 MMWR Langlois, et al TBI-related hospital discharge rates, by age and race – 12 states,* Rates are for 12 states with adequate reporting of race (AK, AZ, CA, CO, LA, MD, MO, NE, NY, OK, RI, SC)

33 TBI Follow-up Study CDC funded CO and SC to develop methods for tracking and interviewing people with TBI yearly to find out what happens to them after they leave the hospital SC is currently interviewing a sample of people with TBI aged 15 years or older each year

34 CO TBI Follow-up Results 60% Reported One or More Needs Most Frequent Included: Improving memory, solving problems better Managing stress and emotional upsets Managing money and paying bills Traveling in the community

35 CO TBI Follow-up Results Needs Least Likely to be Met Finding paid employment Improving job skills Improving memory, solving problems better Controlling alcohol and / or drug use

36 TBI Linkage to Services The 800 number project in Colorado: Collaboration between CSU, CDPHE, BIAC, HRSA, and CDC Showed sending people with TBI a letter about an 800 number for services increased the use of the number 4 to 6 fold

37 Education and Awareness Concussion brochure (English & Spanish version) Physician toolkit for educating about “mild” TBI Developing toolkit for high school athletic coaches

38 CDC TBI Resources Web Page –www.cdc.gov/injury

39 How do CDC TBI Programs Relate to Services? Perhaps states could build “registries” by enhancing their surveillance systems to help people - find out about service needs - link to services

40 Building TBI “Registries” Surveillance Identifying (Personal identifiers and contact info) Linking to services

41 Building on Surveillance to Link People to Services Surveillance data meet the needs of state service agencies for data on the numbers of people with TBI who may need services Legal authority to identify and contact people with TBI included in surveillance allows states to link them to available services

42 Possible CDC Future TBI Activities Identify people with TBI in institutions Expand follow-up studies and include children Expand education and awareness efforts

43 Possible CDC Future TBI Activities “Mild” TBI Initiative Research on how the public interprets the term “mild” TBI Validate case definitions for “mild” TBI Study of the prevalence of disability after “mild” TBI

44 Contact Information Angela Marr, MPH CDC/NCIPC Phone: (770)


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