Characteristics of traumatic brain injury-related healthcare visits across social determinants of health: A population-based birth cohort study
Vincy Chan, Clarissa Serafine Wirianto, Robert Balogh, Juliet Haarbauer-Krupa, Michael David Escobar
Abstract
Traumatic brain injury is a major cause of death and disability worldwide, with almost half of new cases occurring in children, adolescents, and young adults. However, data on injury characteristics stratified by social determinants of health are scarce.
Introduction
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide (1). In 2016, there were over 27 million new cases of TBI globally, with approximately 47% of new cases occurring in those <30 years of age [1]. A population-based birth cohort of individuals born in Ontario, Canada found that 36% of individuals in this cohort sustained a TBI that required medical attention by the age of 25 years.
Methods
Research ethics approval was obtained from the University Health Network. Informed consent was not obtained because only de-identified patient data was accessed for this study on July 30, 2021.
Results
Over 90% of index TBI-related healthcare visits to the ED or acute care occurred before the age of 20 years. The majority (56.4%) of visits were among males and those living in an urban neighbourhood (81.6%) at the time of TBI.
Discussion
This population-based birth cohort study explored the injury characteristics for individuals who experienced a TBI-related healthcare visit to the ED or hospital. Findings from this study identified opportunities for targeted prevention of TBI and early intervention for TBI care across SDoH. In particular, current prevention and education measures are often focused on sport-related injuries [30] and may not be applicable to the general population.
Conclusions
This population-based birth cohort study addressed existing gaps in knowledge and research on TBI to provide foundational data to inform the co-creation of targeted prevention of TBI at the community-level. Findings showed a minority of females, children younger than age 10 years.
Citation: Chan V, Wirianto CS, Balogh R, Haarbauer-Krupa J, Escobar MD (2025) Characteristics of traumatic brain injury-related healthcare visits across social determinants of health: A population-based birth cohort study. PLoS One 20(6): e0323902. https://doi.org/10.1371/journal.pone.0323902
Editor: Eric Anthony Sribnick, Nationwide Children's Hospital, UNITED STATES OF AMERICA
Received: January 2, 2025; Accepted: April 15, 2025; Published: June 12, 2025
Copyright: © 2025 Chan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data reported in this study are available in the ICES repository, under accession DAS 2019-695 (2021 097 025 1000). Data sharing agreements prohibit ICES from making the datasets publicly available; however, access may be granted to those who meet pre-specified criteria for confidential access.
Funding: This study was funded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R03HD104206, awarded to VC. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. URL: https://www.nichd.nih.gov/grants-contracts
Competing interests: The authors have declared that no competing interests exist.
