1. Traumatic Brain Injury in Alaska: Who, How and Where Alaska Native Tribal Health Consortium Injury Prevention Program

2. What is a Traumatic Brain Injury? CDC describes it as: “…caused by a bump, blow, or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.”

3. How do you get a TBI? Many different kinds of events, some that are almost everyday events, can cause a TBI:  Hitting your head when you fall or trip  Crashing your bike, snow machine or ATV  Being in a motor vehicle crash  Injure your head during sports  Being near an explosion

4. How does a TBI affect you? If you or someone else gets a TBI, it can cause temporary or permanent changes in:  Thinking (remembering and reasoning)  Physical abilities (walking, coordination)  Sensation (touch, taste, smell)  Language (understanding, communication)  Emotion (depression, aggression, anxiety)

5. Increased Risk of TBI Who?

6. The Gender Gap Non-fatal TBI Hospitalizations in Alaska 2004-2008

7. Age Differences Non-fatal TBI Hospitalizations in Alaska 2004-2008

8. Age groups and Activities Different age groups have different activities that result in the highest numbers of TBI: Ages (years)Activities with the most TBI 0-9Falls 10-19Motor vehicle, ATV/Snowmachine 20-39Motor vehicle, Assault 40+Falls, Motor vehicle

9. Increased Risk of TBI Where?

10. Region of Patient Residence Non-fatal TBI Hospitalizations in Alaska 2004-2008* All U.S. Rate**: 93 All Alaska Rate*: 92 Alaska Native Rate*: 174 * Crude rates, reported as TBI per 100,000 people ** All U.S. rate for 2002-2006, per CDC.

11. Specific places of occurrence Non-fatal TBI Hospitalizations in Alaska 2004-2008

12. Increased Risk of TBI Is Alcohol a Risk Factor?

13. Yes

14. Alcohol Association by Age Non-fatal TBI Hospitalizations in Alaska 2004-2008

15. Alcohol by Activity Non-fatal TBI Hospitalizations in Alaska, 2004-2008 Cases associated ACTIVITY with alcohol Assault3 out of every 4 Suicide attempt and Snow machine 1 out of every 2 Pedestrian and All-terrain vehicle 2 out of every 5 Motor vehicle traffic 1 out of every 3 All other1 out of every 5

16. Alcohol by Activity Non-fatal TBI Hospitalizations in Alaska 2004-2008 Per cent of cases ACTIVITY Total Cases associated with alcohol Assault 37572% Snow machine 12149% Suicide attempt 2748% Pedestrian 10841% All-terrain vehicle 24039% Motor vehicle traffic 64432% Bicycle 13223% Falls 103418% All other 40818%

17. Increased Risk of TBI How severe?

18. Time in Hospital For TBI hospitalizations from 2004-2008, the length of time patients spent in the hospital: Average:5.6 days (compared to 3.9 for non-TBI injuries) Maximum: 305 days (10 months)

19. Patient destination at discharge Non-fatal TBI Hospitalizations in Alaska 2004-2008

20. Patient’s General Condition on Discharge Condition Frequency % Good, Return to Previous Level of Function861 28 Temporary Disability, Expected to Return 1111 36 to Previous Level of Function Moderate Disability with Self Care133 4 Severe Disability, Dependent155 5 Persistent Vegetative State4.1 Unknown825 27

21. Risks of TBI How much $$?

22. Hospitalization costs Hospitalization costs for TBI in all Alaska averages $29,000 per injury, compared to the $20,000 average for all injury hospitalizations Estimated total per year: $16.7 million Highest hospitalization cost for TBI: $1,010,000

23. Medivac costs These costs vary dramatically depending on the contract with the Medivac company. These are cost ranges Alaska companies provided for actual trips taken: Juneau to Seattle:$17,000 to $37,000 Anchorage to Seattle: $27,000 to $56,000 Nome to Seattle:$37,000 to $75,000 Anchorage to Richmond, VA:$63,000 to $124,000

24. Prevention What is being done?

25. Snowmachine, ATV, and Motorcycle Safety

26. Child Motor Vehicle Safety

27. Gun Safes Reducing harm from guns

28. Ice cleats Home modification Raising awareness

29. ANTHC Traumatic Brain Injury Contacts Jaylene Wheeler, Injury Prevention Coordinator (907) 729-3799jzwheeler@anthc.orgjzwheeler@anthc.org Hillary Strayer, Senior Injury Prevention Specialist (907) 729-3513 hdstrayer@anthc.orghdstrayer@anthc.org Website: http://www.anthc.org/chs/wp/injprev/http://www.anthc.org/chs/wp/injprev/

30. Thank you!