Warning: sensitive content. This article contains a description of brain injuries. Some readers may find the topic traumatizing or upsetting.
Thousands of Canadians live with traumatic brain injury. “Traumatic brain injury (TBI) is a non-discriminative event that could affect anyone.” This statement is not entirely correct. Canadian studies have consistently found higher rates of TBI in marginalized and vulnerable populations.
For example, half of all people without a permanent address report experiencing a recent TBI. Most cases occurred prior to homelessness, but the status itself had a significant role in increasing the life-long risk. The figures are similar for criminalized individuals, with ~50% having been affected by head injuries. Underserved groups were at a higher risk of TBI and were more likely to develop longer-term complications. This could partly be explained by historic systemic barriers to access to healthcare in these groups, as well as stigmatization of TBI. For individuals facing socio-economic challenges, TBI can trigger a vicious cycle of health problems, creating barriers that then contribute to higher risk of recurrent injury.
Currently, each TBI is treated as a single event with most of the treatment focusing on minimizing immediate symptoms. However, TBI is not a single injury, as may appear from its name, it is a continuous process of injury development that spans years following the initial impact. Poor healing of the brain and/or disruption of the normal blood circulation function may underlie other brain network disorders, including epilepsy, depression, and cognitive decline. Such factors could contribute to increased suicide risk and a long-term commitment to anti-anxiety and anti-depression medication.
There is a need for a unifying national strategy that could address the gaps that exist today in long-term management of TBI and break the barriers to better health that some individuals may be facing.
To address this gap, MP for Cowichan-Malahat-Langford, BC, Alistair MacGregor, partnered with Brain Injury Canada, CGB Centre for Traumatic Life Losses; the BC Brain Injury Association; and the Cowichan Brain Injury Society to propose a National Strategy on Brain Injuries. Bill C-277 was met with support across all parties. Under this bill, the Minister of Health, in consultation with the provinces and stakeholders, would focus on creating a novel unifying national strategy aiming to raise awareness about brain injury, improve data collection and analysis, refine guidelines on diagnosis and longitudinal treatment of brain injuries as a chronic disease. Additionally, the Government could cooperate with the international partners to implement a unifying world-wide policy of TBI surveillance, such as exists for infectious diseases and other chronic conditions.
While the novel strategy would require significant initial investment for its implementation, it may play a significant role in reducing long-term health care burden and expenses, expected at $8.1 billion by 2031. Additionally, it will provide physicians with better tools for prevention of complications in populations at risk, dismantling the vicious cycle of marginalization leading to higher injury risk and vice versa. One thing is clear, however: This is the first step towards an improvement of injury management in local communities and will save lives.
Left photo by Christopher Austin, Right photo by Accuray
