Traumatic brain injury (TBI) is a serious public health problem that can significantly impact a person's
quality of life, the healthcare system, and society as a whole. Health
disparities in TBI refer to the unequal distribution of TBI-related morbidity
(the state of having a specific illness) and mortality (the number of
deaths due to a particular disease) across different populations. These
disparities can be due to various factors, including socioeconomic status,
race and ethnicity, and age. Understanding which groups are at greater
risk of sustaining, dying from, or receiving inadequate care related to
TBI is crucial to better health outcomes for ALL people.
Socioeconomic status plays a significant role in a person's higher
likelihood of living in crowded and poorly maintained (exposure to lead
paint and secondhand smoke, for example) housing situations, as well as
living in areas with higher crime rates, which can lead to violence and
falls. People from low-income households are at two-to-four times greater
risk of suffering a TBI than those who have a higher income. People making
a lower income are also more likely to work in dangerous jobs, such as
construction and manufacturing, which can increase their risk for head injuries.
Socioeconomic status affects a person's ability to afford quality health
care, health insurance, and access to quality health care providers within
a "near enough" geographic area. Additionally, individuals struggling
financially to afford basic daily living necessities (food, shelter, clothing,
transportation) are also at an increased risk of not receiving adequate
care if they have sustained a TBI. These factors can make getting necessary
and sometimes life-saving care even more difficult after a TBI.
Race and Ethnicity
Racial disparities in sustaining a TBI tend to go hand-in-hand with those
explained in the socioeconomic section above. A 2021 study published in
Frontiers of Surgery indicated that people of color are more than twice as likely to die as
white people after sustaining a traumatic brain injury. Non-Hispanic black
and Hispanic people are also at an increased risk of sustaining a TBI
and receiving inadequate rehabilitation and follow-up care after sustaining
a TBI than other racial groups. These factors increase the likelihood
of poorer physical, mental, and return-to-work-related outcomes for people
of color after TBI than any other racial demographic group.
Older adults, especially those over 75, have the highest rates of TBI-related
hospitalization and death than younger people. Age-related changes in
the brain can contribute to the brains of older people becoming more fragile
and susceptible to injury. Older adults are also more likely to have medical
conditions that can increase their risk of TBI – such as stroke,
heart disease, or diabetes. With the increase in the number of medical
diagnoses often comes an increase in prescribed medications, which can
also increase fall risk for older adults.
The impact of TBI is significant. It can be even greater for people who
are already marginalized. People from low-income households, people of
color, and older adults may have less access to quality healthcare and
may be less likely to receive the support they need to recover from a TBI.
Plenty can be done to address health disparities in TBI. These include
increasing awareness of TBI among healthcare providers and the public,
improving access to quality healthcare, providing support services for
people who have experienced a TBI, and reducing the risk factors for TBI.
By taking these steps, we can help to ensure that
EVERYONE can reduce their TBI risk and has an equal opportunity to recover from
TBI and live a healthy and productive life.