Anyone can be affected by brain injury – but some groups are at greater risk.
Sunnybrook expert says an equity lens to prevention is key to reducing harm.
If you or someone you care about has ever experienced a traumatic brain injury (TBI) – such as a concussion or injury from a motor vehicle collision – then you know the impacts can be life-changing.
TBI is different for everyone but it often leads to a range of physical, emotional, behavioural, and cognitive changes that impact a person’s health and daily activities.
Some groups are impacted by TBI more than others. At Sunnybrook’s latest Speaker Series, Shaelyn Fitzpatrick, Injury Prevention Educator with the Centre for Injury Prevention at the Tory Trauma Program, discussed some of the reasons why this is the case.
Fitzpatrick explained that social determinants of health are a major factor. These can include race, ethnicity, economic status, gender identity, age and sex. Social determinants of health affect a person’s risk of injury and disease, as well as access to health services and outcomes.
“In order to work towards reaching health equity, we need to address the underlying social determinants that create barriers and disproportionately create unfair distribution and access to services and supports,” Fitzpatrick said.
Fitzpatrick is a registered nurse by training. She is also the host of the second season of a podcast called Injury is NOT Equal, produced by the Centre for Injury Prevention to increase awareness about the inequities in injury risk and experience.
Season two of the podcast focused on TBI, which has a significant impact on society. According to Brain Injury Canada, about two percent of Canada’s population lives with TBI. By 2031, TBI is expected to be one of the most common neurological conditions affecting the country’s population.
Fitzpatrick and her guests on the Injury is NOT Equal podcast explored some of the intersecting identity, systemic and socioeconomic factors that cause certain groups to be impacted more than others.
For instance, according to the World Health Organization, one in three women experience intimate partner violence — placing them at greater risk of sustaining a TBI.
“It is estimated that for every NHL player who suffers a brain injury, approximately 7,000 Canadian women experience the same as the result of intimate partner violence,” Fitzpatrick said. “This equates to about 250,000 new cases of IPV related brain injury each year in Canada.”
Despite these numbers, Fitzpatrick said, there is still little understanding among the public and healthcare providers about the association between TBI and intimate partner violence.
Risk of TBI also increases with age, Fitzpatrick explained. Seniors aged 65 and older are significantly more likely to sustain a head or brain injury, mostly due to falls and car collisions
“On average, older adults with TBI experience higher rates of death and disability, slower recovery and greater impacts to cognition, functional ability and psychosocial outcomes,” she said.
It is a common misconception that falls are an unavoidable part of aging, Fitzpatrick added, but in reality, they often result from factors such as deconditioning which can be prevented.
Prevention strategies which address both the immediate risk factors of injury, as well as the underlying social conditions that create risk factors, is at the very heart of what Sunnybrook’s Centre for Injury Prevention does.
The Centre’s P.A.R.T.Y. Program, which offers injury prevention workshops for teens, and its STOP THE BLEED®initiative, which trains members of the public to manage massive bleeding, are two successful examples.
The Centre also runs the BRAVE Program, which stands for “Breaking the cycle of violence with empathy.” It is a violence intervention program for youth that offers wraparound services to patients and families who have experienced a stabbing or gunshot injury, with the aim of reducing re-injury or retaliation.
The Centre for Injury Prevention also work to improve access to its programs to communities which are more vulnerable to injury.
At the end of the day, prevention strategies that are informed by an equity lens will be more successful at reducing injury such as TBI, Fitzpatrick said.
“If we can address factors such as income disparity, discrimination and systemic racism, we could see a huge impact on many aspects of individuals’ lives including their health and risk of injury,” she concluded.