Top 5 Takeaways

1. High TBI-Related Death Rates in Rural Areas: States with higher percentages of rural residents had significantly higher rates of TBI-related deaths.
2. Leading Cause of TBI-Related Deaths: Suicide was the leading cause of TBI-related deaths in 43 states.
3. Geographic Variations: The lowest TBI-related death rates were in the Northeast, while the highest were in the South and West.
4. Significant State Differences: TBI-related death rates varied widely by state, with New Jersey having the lowest rate and Alaska the highest.
5. Importance of Evidence-Based Prevention: Expanding evidence-based prevention strategies is crucial, especially in states with high rates due to suicide, unintentional falls, and motor vehicle crashes.

Original Article Author and Citation

Corresponding Author

Jill Daugherty, xdu1@cdc.gov

Suggested Citation

Daugherty J, Zhou H, Sarmiento K, Waltzman D. Differences in State Traumatic Brain Injury–Related Deaths, by Principal Mechanism of Injury, Intent, and Percentage of Population Living in Rural Areas — United States, 2016–2018. MMWR Morb Mortal Wkly Rep 2021;70:1447–1452. DOI: http://dx.doi.org/10.15585/mmwr.mm7041a3

Summary

This study analyzed TBI-related deaths in the United States from 2016 to 2018 using NVSS mortality data. It found significant variations in TBI-related death rates across states, with higher rates in rural areas and lower rates in urban areas. Suicide was the leading cause of TBI-related deaths in most states, followed by unintentional falls and motor vehicle crashes. The findings highlight the need for targeted, evidence-based prevention strategies to reduce TBI-related deaths.

Methods

Data from NVSS’s multiple cause-of-death files for 2016–2018 were combined to estimate TBI-related deaths. TBI-related deaths were classified using ICD-10 codes. The data were stratified by state, intent, and mechanism of injury. U.S. Census Bureau data were used to determine the percentage of each state’s population living in rural areas. Statistical analyses included calculating TBI-related death rates, percentage differences, and Pearson correlations.

Discussion

The study found significant geographic variations in TBI-related death rates, with higher rates in rural areas and the South. Suicide was the leading cause of TBI-related deaths in most states. The findings suggest that rural residents may face barriers to accessing emergency and specialized TBI care. Differences in state injury prevention policies and risk factors also contribute to the variations in TBI-related death rates.

Conclusion

Expanding evidence-based prevention strategies is essential, particularly in states with high TBI-related death rates due to suicide, unintentional falls, and motor vehicle crashes. States can implement various strategies identified in CDC’s technical packages to address these leading causes of TBI-related deaths.

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