Every year in the United States, around 2.5 million people sustain a traumatic brain injury (TBI), which can result in a long-term disability or even death. Older adults are disproportionately affected, with those 75 and older making up nearly one-third of all TBI hospitalizations and over a quarter of TBI deaths.
This study will consider the common causes of TBIs, the states, industries, and people disproportionately affected, key TBI symptoms and consequences, and some of the simple measures that can be deployed to keep TBI injuries to a minimum.
First, let’s closely consider what a TBI is, including the different TBI ‘tiers’: three levels of trauma severity.
The Three Levels of TBI Severity
A traumatic brain injury (TBI) occurs when a sudden blow, jolt, or penetrating impact disrupts normal brain function. In the United States, TBIs are a significant public health concern, capable of causing both disability and loss of life.
Depending on its severity, the effects of a TBI might be immediately apparent, or it may cause long-term complications that affect physical health, thinking, behavior, and overall quality of life.
In terms of TBI types, they’re often classified as one of three tiers: mild, moderate, and severe. Each TBI tier is defined by differences in symptoms, duration of unconsciousness, and neurological impact.
Mild TBIs (or concussions) are by far the most common type, and account for more than 75% of all TBIs (according to Cleveland Clinic data).
These types of TBI typically involve a minor change in mental status (confusion, disorientation, or a short period of unconsciousness) and often occur during falls, sporting activities, or minor vehicle collisions.
Moderate TBIs involve fairly significant neurological disruption. They can include a loss of consciousness that lasts between 30 minutes and 24 hours, abnormal imaging findings, or prolonged cognitive impairment. An estimated 15 moderate TBI cases per 100,000 people occur every year.
Severe TBIs typically involve long-term unconsciousness, penetrating injuries, or substantial structural brain damage. This type of TBI occurs at a rate of 14 to 21 cases per 100,000 people every year (figures depend on whether pre-hospital deaths are recorded).
The Centers for Disease Control and Prevention makes it clear that all three categories represent a spectrum of brain trauma that can lead to lasting cognitive, behavioral, and physical consequences. While mild TBIs are most frequent, moderate and severe TBIs trigger a disproportionate share of long-term disability, hospitalization, and financial burden.
However severe, TBIs occur in a number of ways. Here are some of the most common.
The Common Causes of TBI
A wide range of situations and circumstances can lead to a TBI. Falls are the most common cause (28% of all TBI incidents), from seemingly innocuous slips and falls to serious head injuries.
This category usually comprises vulnerable groups such as young children (often still developing coordination) and older adults (often struggling with balance or mobility), a factor that means fall prevention remains a key public health priority.
Motor vehicle crashes account for 20% of TBIs. Whether it’s a high-speed crash, a rear-end impact, a motorcycle accident, or a pedestrian struck by a vehicle, the sudden force involved in a motor vehicle accident can lead to a devastating brain injury.
19% of TBIs are due to being hit by or colliding with an object. This category includes workplace accidents involving equipment, sports-related impacts, and falling objects: broadly, any situation involving unexpected blunt force to the head.
12% of TBIs fall into the ‘Other/Unspecified’ category. This group covers less common or more difficult-to-classify causes such as environmental hazards, recreational activities, and injuries where the exact cause may be unclear or unreported.
Assaults represent 11% of TBI cases, with intentional harm a worrying and significant contributor to brain injuries. This category includes interpersonal violence, domestic incidents, and other examples of deliberate force causing head trauma.
These combined figures illustrate that TBIs arise from a complex mix of unintentional and intentional incidents, with sudden impact the common factor. They also highlight the importance of targeted prevention strategies (improving fall safety, enhancing road safety, enforcing workplace protections, or addressing violence) to reduce the overall burden of traumatic brain injuries across communities.
When we consider the age groups most affected by TBI hospitalization, we can clearly see the vulnerability over-75s represent.
The Age Groups Most At Risk Of TBIs
Traumatic brain injuries affect people of all ages, yet the burden is unevenly distributed. Older adults experience the highest risk by far, with individuals aged 75 and over accounting for nearly one-third (31.6%) of all nonfatal TBI hospitalizations.
Other significantly affected age groups include those aged 65-74 (14.4%), 55-64 (12.8%), 45–54 (9.5%), and 25–34 (9.4%), figures that clearly show how injury rates steadily rise with age.
For seniors, TBIs are rarely due to violence or high-impact activity; in the vast majority of cases, they’re due to a fall. Age-related balance issues, medication side effects, reduced bone density, and chronic health conditions all serve to make fall-related TBIs the leading cause of hospitalization and death in older adults.
In contrast, children and teens suffer TBIs for entirely different reasons. Young people frequently sustain head injuries during frenetic sporting and playground activities, roughhousing, and numerous other forms of physical play, which combined account for hundreds of thousands of annual emergency room visits.
The TBI Gender Disparity
As well as age, gender is another TBI differentiator. Men consistently make up about 60% of TBI-related hospitalizations and around 73% of TBI-related deaths. These figures reflect their increased involvement in motor vehicle crashes, physical altercations, risky behavior, and hazardous occupations such as construction and transportation.
Males of all ages experience significantly higher TBI rates than females, a consistent pattern from childhood through adulthood.
Boys are heavily represented in high-impact sports like football, hockey, soccer, wrestling, and basketball, and more often engage in rough physical play and other activities where falls and collisions are common.
As they age, young men are more frequently involved in motor vehicle crashes, motorcycle accidents, assaults, and high-speed recreational activities, all of which dramatically increase the likelihood of moderate to severe TBIs.
Adult men also dominate TBIs suffered while carrying out tasks in construction, manufacturing, transportation, law enforcement, and agricultural industries, where falls from heights, machinery accidents, and struck-by-object injuries frequently occur.
Behavioral factors also play a role, with men more likely to take physical risks, improperly use protective gear, and fail to report concussion symptoms or seek treatment, increasing the likelihood of complications and repeat injuries. As a result, men not only sustain more TBIs but also experience more severe (and fatal) forms of head trauma.
Women, who represent 40% of TBI-related hospitalizations and 27% of TBI-related deaths, experience traumatic brain injuries for a wide range of reasons. That said, the burden is often underestimated because most TBI research has historically focused on men.
Falls are a major contributor to TBIs among women, especially as they grow older. Younger women and adolescent girls face an elevated TBI risk due to sports and recreational activities.
In fact, female athletes experience higher rates of concussion than males in sports like soccer, basketball, and softball, and may experience longer recovery times due to differences in neck strength, hormonal cycles, and injury biomechanics. Cheerleading, gymnastics, horseback riding, and cycling are additional high-risk activities that exacerbate the rate at which women and girls sustain head injuries.
Despite these patterns, women are still less likely to be diagnosed, less likely to seek care, and often receive less follow-up attention compared to men with similar injuries. As a result, many women live with persistent symptoms such as headaches, cognitive fog, dizziness, and mood changes without realizing these issues stem from an untreated concussion.
Women also face high levels of intimate partner violence (IPV). Studies show that as many as 75% of domestic violence survivors sustain at least one TBI, with many also suffering repeated injuries that never receive medical attention.
IPV TBIs are caused by blows to the head, being shaken, or being throttled, all of which can cause serious, long-term neurological harm, especially if survivors do not seek emergency care.
A shocking 1.6 million domestic violence survivors suffer from TBIs every year: that number, from Ohio Domestic Violence Network figures, far exceeds official records and underscores how severely IPV-related TBIs are overlooked in ‘official’ national statistics.
There are also disparities when we consider the states that suffer most from TBIs.
The States Most Affected By Fatal TBIs
In 2024, Alaska led U.S. TBI death figures ranked per 100,000 residents. The state suffered 112 fatalities at a rate of 15.3 (per 100,000). This pattern is consistent with Alaska’s broader injury trends: its remote location, extreme weather, prolonged emergency response times, and high rates of falls and transportation-related trauma all compound the risk of severe head injuries.
Montana follows with a TBI mortality rate of 12.5 per 100,000, reflecting similar rural challenges and an older population disproportionately vulnerable to fall-related TBIs.
It’s a similar story in Wyoming: the state’s 11.1 deaths per 100,000 further underscores how sparsely populated states face higher injury fatality rates due to isolation and limited neurological specialty care.
Wisconsin’s 627 deaths (10.6) place it well above national average numbers and highlights the combined impact of winter slip-and-fall injuries, rural highway crashes, and an aging population. South Dakota (10.2) and Idaho (9.6) observe the same patterns: small populations, long travel distances for emergency care, and environmental factors that elevate injury severity.
South Carolina (one of the more populous states on the list) recorded 518 deaths (9.6), numbers that point to broader risk factors such as high motor-vehicle crash rates and large elderly populations.
Even heavily populated states with a robust medical infrastructure appear in the top 10. Ohio reported 1,089 deaths (9.2 per 100,000), reflecting its high rate of roadway fatalities and industrial injuries, while Maryland’s 564 deaths (9.1) show that exceptional medical facilities can’t necessarily offset a particularly severe rate of TBI incidents.
Kansas completes the list of ten states suffering most from TBIs with 269 deaths (9.1 per 100,000). Its presence in the rankings reinforces the consistent pattern of central and mountain-region states featuring rural living and delayed access to trauma care, suffering elevated TBI fatality risk.
Overall, these figures show that TBI deaths are not just a localized issue or tied to a single cause. Instead, they reflect a complex combination of geography, age, transport conditions, environmental hazards, and access to rapid, specialized care.
States with small, dispersed populations and harsh climates suffer, as do larger states due to urban crash patterns and aging residents. The data clearly shows that TBI risk looks very different depending on where you live, with some states facing far more issues than others.
The Industries With Highest TBI Rates
Jobs in some industries represent a markedly elevated TBI risk, yet the accrued injuries often evade full regulatory scrutiny. According to U.S.
Bureau of Labor data, construction, warehousing/transportation, professional driving, agricultural roles, public safety and emergency service roles, and law enforcement are all especially vulnerable to TBIs from falls, being struck by objects, or motor vehicle incidents.
Also vulnerable to these factors are those carrying out roles in mining, manufacturing, utilities, waste management, and postal services.
Historically, the agriculture, forestry, fishing & hunting industry has suffered the highest fatal occupational TBI rate (5.7 per 100,000 workers per year), with logging alone reaching 29.7 fatalities per 100,000 workers.
In industries like the construction sector, TBI injuries cause more than half of all fatalities, primarily due to falls. This is clear evidence that frontline workers in physically demanding and hazardous environments sustain brain trauma injuries at vastly disproportionate rates.
And Occupational Safety and Health Administration (OSHA) oversight frequently falls short. Many TBIs go unreported, particularly if they’re due to delayed-onset symptoms (such as a mild concussion evolving into serious impairment), or when employers simplify them as a vague ‘head injury’.
Enforcement resources are limited, and industry‐specific guidance regarding TBI prevention is both insufficient and inconsistent. This ultimately means that thousands of work-related brain injuries go unreported. One consequence of this is when a TBI that might have been dealt with early needlessly becomes a serious long-term condition.
TBI Symptoms and Long-Term Consequences
TBIs can trigger a wide spectrum of symptoms and long-term health problems. The CDC notes that people with moderate or severe TBI often develop persistent cognitive issues (trouble concentrating, understanding, or remembering), motor function problems (weakness, balance, and coordination problems), vision and hearing changes, and emotional or behavioral changes (irritability, anxiety, depression, and impulse-control issues).
Five years after suffering a moderate or severe TBI, an estimated 57% of survivors are moderately or severely disabled. In addition, 55% are not working despite having been employed at the time of injury, while 50% have been rehospitalized at least once.
33% need help to carry out everyday activities, 12% live in nursing homes or equivalent institutions, and life expectancy for victims of a moderate to severe TBI is 9 years shorter than average rates.
Studies also show that a history of TBI increases later-life risk of dementia and other neurodegenerative conditions. Clearly, a TBI often represents the onset of a chronic health condition and can be much more than a one-time event. And there are economic as well as physical and mental factors to consider.
The Economic Cost Of TBIs
The economic impact of TBIs in America is severe, with CDC data confirming tens of thousands of TBI-related deaths and hundreds of thousands of hospitalizations each year.
Nonfatal TBIs alone cost U.S. healthcare patients $40.6 billion (around $13,500 per TBI). And that figure doesn’t include the cost of lost productivity, long-term disability, or informal caregiving.
A U.S. Injury Prevention (2025) study provides more detailed per-injury cost rates. For example, the financial burden of a non-fatal TBI treated in an emergency department was $4,529 in medical bills and $1,503 in lost wages.
Because so much of this financial burden might easily be avoided, public-health agencies emphasize preventative strategies. They include reducing the number of falls in older adults (home safety modifications, balance/strength training, vision checks, and regular medication reviews), improving motor-vehicle safety (higher use of seat belts, child restraints and helmets, and targeted drunk or distracted driving prevention), promoting sports and recreation safety (the use of proper helmets, tighter rule enforcement, and concussion protocols), and addressing assaults and self-harm through domestic violence prevention, firearm safety, and mental-health support.
Combined, symptom management, long-term rehabilitation, and targeted prevention policies are crucial if we want to reduce the human and economic TBI toll in the United States.
TBIs: A Future Roadmap
Traumatic brain injuries (TBIs) are a major U.S. public-health burden, with 2.5 million annual cases and a high proportion of the population living with a long-term disability.
TBIs occur when a blow, jolt, or penetrating injury disrupts brain function and can range from a mild concussion to a severe, life-threatening trauma. Mild TBIs account for more than 75% of all cases; though less frequent, moderate and severe TBIs create the greatest long-term effects, and lead to high hospitalization numbers, disabilities, and significant economic costs.
The CDC notes that over half of people with moderate or severe TBI remain disabled five years after injury, while many struggle with cognitive issues, compromised motor function, and emotional effects.
The TBI burden is heaviest for older adults. People aged 75 and older account for nearly one-third of all TBI hospitalizations and more than one-quarter of TBI-related deaths, mainly due to falls.
Children and teens most often sustain TBIs during sports, plus other general physical activities. Men suffer 60% of TBI hospitalizations and 73% of TBI deaths, driven by higher exposure to motor-vehicle crashes, assaults, risk-taking behavior, and hazardous occupations.
Women face unique vulnerabilities, including higher concussion rates in certain sports, fall-related TBIs later in life, and a substantial (albeit severely underreported) TBI burden due to intimate partner violence. Research shows 30% to 75% of IPV survivors sustain head injuries, with an estimated 1.6 million women suffering a TBI every year due to a domestic violence assault.
For seniors, the primary driver of TBIs is not violence or high–impact activity, but something far more commonplace: falls. Age–related balance issues, medication side effects, reduced bone density, and chronic health conditions all contribute to fall–related TBIs being the leading cause of hospitalization and death in older adults
TBI risk also varies sharply across the U.S., with rural areas Alaska, Montana, and Wyoming reporting the highest fatal TBI rates, due to long distances to trauma care, extreme weather, and elevated rates of falls and transportation injuries.
Several other rural and mid-sized states (Wisconsin, South Dakota, Idaho, and South Carolina) also show disproportionately high TBI mortality rates. Ohio and Maryland also appear in the list of ten states with the highest TBR rates, due to factors such as an aging population, road danger, and industrial injuries.
Workplace injuries are another significant TBI factor, especially in sectors like construction, agriculture, logging, transportation, warehousing, law enforcement, and manufacturing.
The agriculture, forestry, fishing, and hunting sector historically records the highest fatal TBI rate (5.7 per 100,000 workers), with logging reaching nearly 30 fatalities per 100,000.
Over half of the construction industry’s fatalities are due to TBIs from falls. OSHA oversight misses many TBIs, often due to misclassification or underreporting, or if they only present hours or days later.
TBIs can lead to profound long-term consequences. Survivors may struggle with simple tasks due to persistent cognitive impairment, memory problems, balance and coordination issues, sensory changes, severe emotional effects, depression, and anxiety.
Many face lifelong disability, unemployment, and repeated hospitalizations. Studies show people with moderate or severe TBI may suffer significantly shortened lifespans and a higher risk of dementia and other neurodegenerative disorders.
Additionally, the TBI economic burden is enormous. Nonfatal TBIs alone generate $40.6 billion in annual healthcare spending. Hospital-treated TBIs cost (on average) $4,529 in medical bills plus $1,503 in lost productivity, plus the extra cost of long-term rehabilitation, caregiving, or reduced lifetime earnings.
Because so many TBIs are preventable, public-health strategies focus on fall prevention for older adults, improved helmet and seat belt use, safer driving practices, better workplace safety, and expanded violence-prevention and mental-health programs.
Overall, the data makes it resoundingly clear. TBIs are much more than one-off medical injuries: they’re a major nationwide issue, the severity of which can depend on age, gender, environment, occupation, and state-level conditions. Ultimately, TBI data tells us that one accidental fall can mean lifelong consequences for millions of Americans.
At Siegfried & Jensen, we know how a simple fall can devastate lives. We have over 30 years of experience getting our clients justice and maximum compensation. Our team is ready to do the same for you.