Public Health Response to Traumatic Brain Injury Jeneita Bell, MD, MPH Medical Officer LCDR, USPHS Commissioned Corps National Center for Injury Prevention and Control Division of Unintentional Injury Prevention

Overview History of CDC TBI Surveillance Congressional mandates and authorizations Response to Congress TBI Model Systems

CDC's Traumatic Brain Injury Surveillance Program 1989 — promoted development of a multistate TBI surveillance program Federal Interagency Head Injury Task Force Report Funding and technical assistance Colorado, Oklahoma, Missouri, and South Carolina 1995 — published Guidelines for Surveillance of Central Nervous System Injury Ensure valid and timely information Define the data elements necessary to describe TBI Core elements readily available to most State health departments Better information on the public health impact of brain injuries

The Traumatic Brain Injury Act of 1996 Develop a uniform reporting system Research effective strategies for preventing TBI Implement public information and education programs Provide technical assistance to public entities Authorized at $3 million for fiscal years 1997–1999

CDC Response – TBI Act of 1996 Report to Congress on TBI -1999 Incidence Prevalence of TBI TBI-related disability TBI surveillance systems funded in 19 states Follow-up studies Colorado and South Carolina Funded and provided technical assistance

TBI Act Amendments of 2000 Signed as Title XIII of the Children’s Health Act of 2000 Implement national education campaign Fund States or their designees to operate a TBI registry Determine the incidence and prevalence of TBI in all age groups in the general population Determine the incidence and prevalence of mild TBI

CDC Response – TBI Act Amendment of 2000 CDC Heads Up program (2004) TBI-related deaths, hospitalizations, and ED visits Funded states to link rehabilitation and social services CDC Mild TBI Work Group Future of registries State-based CDC surveillance systems as registries Report to Congress (2003) South Carolina studies of TBI among prisoners National Education and awareness campaign which led to heads up 2004 that iIntends to reduce the incidence and the long term consequences of TBI in the US. that included standard clinical and surveillance definitions for mild TBI and the methods to estimate the burden of this serious public health problem US (NCIPC 2003). Funded South Carolina to conduct studies of TBI among prisoners

Reauthorization of the TBI Act of 2008 Collaboration between civilian and military registries Determine the incidence of TBI and prevalence of TBI-related disability Report national trends in TBI Identify common rehabilitation interventions Identify interventions that can prevent or remediate secondary neurologic conditions Develop practice guidelines TBI rehabilitation Determine the incidence of TBI and prevalence of TBI related disability in all age groups and racial and ethnic minority groups Develop practice guidelines TBI rehabilitation SUBJECT TO THE AVAILABILITY OF INFORMATION

CDC Response –Reauthorization Act of 2008 Reports to Congress Military (DoD, VA, NIH) Civilian (NIH and Expert panel of research scientists) TBI-related deaths, hospitalizations, and ED visits, 2002–2006 Demographic characteristics External cause of injury Trend data Interagency Agreement Department of Education, National Institute of Disability and Rehabilitation Research TBI Model Systems

Thank you For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: http://www.cdc.gov The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for Injury Prevention and Control Division of Unintentional Injury Prevention