Traumatic brain injury: an underappreciated public health issue

The public health consequences of traumatic brain injury (TBI) are currently woefully underappreciated. The burden created is often presented as number of deaths and injuries, with the cost calculated by the expense of ongoing care. However, many patients and their families live with the psychological consequences of minor TBI that have hidden costs such as the inability to hold down work, disinhibited (often aggressive or easily agitated) behaviour, and altered mood states.1 The increased incidence of brain injury within vulnerable populations—especially homeless people,2 and the prison3 and refugee4 populations—is considerable, and many of these people enter a downward spiral of head injury associated with altered behaviour, alcohol, and further head injuries.