Traumatic Brain Injury: Health Determinant

Traumatic brain injury is a primary cause of death and disability worldwide. Health determinants refer to a range of factors including personal, social, economic and environmental which influence an individuals health. Determinants of health fall into different categories which are policymaking, social factors, health services, individual behavior, and genetics. Traumatic brain injury occurs when forces from the external environment cause damages to the brain. TBI is associated with: loss of consciousness, memory disturbances, confusion, and neurological signs.TBI can also cause social, cognitive and behavioral symptoms.

The occurrence of TBI is influenced by personal, social, economic and environmental factors. 50 % of all traumatic brain injury occurs in alcohol and drug abusers or are caused by people who abuse drugs1. Most traumatic brain injuries occur in the afternoons in the evenings, weekends and summer months. Children are more likely to get traumatic brain injuries after school.50% of all traumatic brain injury in individuals less than 75 years are due to transportation accidents involving motorcycles, automobiles, and pedestrians. The leading cause of traumatic brain injury in individuals more than 75 years is falling. Around 20 % of all traumatic brain injury is from violence such as firearms assaults and child abuse. There is also a minor number of traumatic brain injury caused by sports injuries. Certain medications and conditions make the elderly more susceptible to traumatic brain injury2. Occupations such as the military personnel predispose people to higher chances of getting brain injuries from firearms. People working in building and construction companies are also predisposed to brain injuries because of the nature of their work. Individuals with certain diseases such as epilepsy and Alzheimers that cause fainting are at a higher risk of getting a traumatic brain injury. African-Americans are at an increased risk of getting a traumatic brain injury. Also, people of low social, economic status have higher chances of getting a brain injury. People with a prior history of traumatic brain injury are more likely to suffer from another one. Knowledge of the importance of safety measures such as helmet use, automobile safety, seat belt use and protective gear influence the occurrence of traumatic brain injury. People who have precise knowledge about safety measures and who apply safety measures are less likely to experience traumatic brain injury.

The populations most affected by Traumatic brain injury include young children less than four years, alcoholics, young adults and old people aged 75 years and above. People aged 75 years and high are more likely to stumble and fall hence sustaining severe brain injuries. Traumatic brain injury is commonly found in males than females. This is because men are more likely to work in the industries, more involved in high-risk sports, and they are placed in dangerous situations during a war5. Children less than four years old have higher chances of getting traumatic brain injury because their brains are not well developed and their bones have not ossified hence they are more prone to these injuries. Research has shown that people living in the rural areas are more likely to get traumatic brain injury than the urban populations.

The role of interventions in traumatic brain injury is to attain the highest level of independent function for participation in the daily activities. Interventions achieve this by; assisting the individual in gathering new skills and strategies, facilitating successful communication, promoting engagement and appropriate development, training use of multimodal communication system and training caregivers and families how to effectively communicate with individuals with traumatic brain injury to increase communication competence4. Most patients with traumatic brain injury suffer from cognitive, communication and swallowing disorders. The interventions include; cognitive communication treatment, compensatory strategy training, sensory stimulation, met cognitive skills training and speech therapy2. Policies both at the local, federal and state level affect individual and population health. Systems can reduce the number of traumatic brain injury by offering education, enforcement and regulation of safety laws, engineering and technology safety and economic incentives. Driver education is provided in all countries to ensure the safety of automobile transport6. All drivers should have a driving license. Also, Public training is usually carried out on the importance of safety seat belts. There are also laws promoting safety such as motorcycle helmet use, no driving under the influence of alcohol and use of protective gear during work.

Patients with traumatic brain injury are most likely to have a reduction in their physical and cognitive abilities that may lead to behavioral and emotional changes. This affects their ability to take food orally, and they may get malnutrition. Some patients lose their sense of smell and taste and even appetite causing them not to take balanced diets. Also, some patients may not be able to swallow food due to excessive injury to the brain. Dieticians then have to ensure that these patients are appropriately fed with the right amount and the right consistency of food. The dieticians have to ensure that these patients get balanced diets and enough nutrients for proper and quick recovery. Proper nutrition is essential for the management of people with traumatic brain injury3. Malnutrition is associated with increased medical complications, prolonged hospital stay, and more unfortunate functional outcome. A well-nourished person will recover better and faster compared to a malnourished person. The dieticians ensure that patients with traumatic brain injury are fed appropriately according to their weight, fluid, wounds calories and protein requirements.

In conclusion, traumatic brain injury is a significant cause of death and disability worldwide. The most common cause of traumatic brain injury is motor vehicle accidents accounting for 50% of all traumatic brain injury. Traumatic brain injury is associated with several health determinants such as low social, economic status, the male gender, and specific occupations such as the construction and building industry, alcohol abuse and individual factors such as the use of safety belts in vehicles. Traumatic brain injury leaves most individuals with disabilities. Therefore people need to be educated on the importance of taking safety measures such as helmet use, automobile safety, seat belt use and protective gear. There are interventions which can help the individuals affected by traumatic brain injury live a healthy happy life. The interventions include; cognitive communication treatment, compensatory strategy training, sensory stimulation, met cognitive skills training and speech therapy. Proper nutrition is necessary for the management of people with traumatic brain injury for quick recovery and reduced hospital stay. Malnutrition is associated with increased medical complications, prolonged hospital stay, and more unfortunate functional outcome. Therefore dieticians play a vital role in the recovery of patients with traumatic brain injury by ensuring that these patients get balanced diets and enough nutrients for proper and quick recovery.

Reference List

1. Roozenbeek B, Maas A, Menon D. Changing patterns in the epidemiology of traumatic brain injury. Nature Reviews Neurology. 2013;9(4):231-236. doi:10.1038/nrneurol.2013.22.

2. Wilson B, Winegardner J, van Heugten C, Ownsworth T. Neuropsychological Rehabilitation. London: Taylor and Francis; 2017.

3. Koehler R, Wilhelm E, Shoulson I. Cognitive Rehabilitation Therapy For Traumatic Brain Injury. Washington, D.C.: National Academies Press; 2013.

4. Gibson R, Purdy S. Mental health disorders after traumatic brain injury in a New Zealand caseload. Brain Injury. 2015;29(3):306-312. doi:10.3109/02699052.2014.896471.

5. Prince C, Bruhns M. Evaluation and Treatment of Mild Traumatic Brain Injury: The Role of Neuropsychology. Brain Sciences. 2017;7(8):105. doi:10.3390/brainsci7080105.

6. Gillard A. Traumatic Brain Injury. Detroit, MI: Greenhaven Press; 2014.