Statistics on brain injury

The source for each statistic (or statistical statement) can be found on the source page at this link. Each number next to a statistic below correlates to the appropriate source.


Despite the prevalence of brain injury in Canada, it is difficult to gather accurate statistics on a regular basis because we rely on hospital and doctor reporting. Many brain injuries are not actually reported at the time of injury (or at all), which impacts the statistics.

A key part of Brain Injury Canada’s advocacy plans is to bring more attention to brain injury, its impact, and the need for more up to date information. We have compiled currently available statistics related to brain injury on this page to help those researching or reporting on brain injury in Canada. If you will be quoting any of these statistics, please include proper sourcing back to this page and Brain Injury Canada.

Topics for statistics on this page include:


Traumatic brain injury

Traumatic brain injury (TBI) general statistics
By 2031, traumatic brain injury (TBI) is expected to be among the most common neurological conditions affecting Canadians, along with Alzheimer’s disease and other dementias, and epilepsy [1].

Traumatic brain injury (TBI) is a leading cause of disability globally. In Canada, 2% of the population lives with a TBI, and there are 18,000 hospitalizations for TBI each year. One-third of individuals with a TBI are women, and TBI is particularly common early in the reproductive years (15-24 years), with intimate partner violence and accidents being major causes. Women with TBI are more likely than men to experience mental health problems post-injury [2].

Please note: The following series of stats has been extrapolated from United States data to the population of Canada.

TBI occurs at an annual rate of 500 out of 100,000 individuals.  That is approximately 165,000 in Canada. This equals 456 people every day, or one person injured every 3 minutes in Canada [3].

TBI occurs at a rate of 100 times that of spinal cord injury [4].

When injury due to stroke or other non-traumatic causes is included, close to 4% of the population lives with brain injury. That equates to over 1.5 million Canadians living with acquired brain injury [5].

A comparison of TBI and other prevalent disease, illness or injury
26,900 Canadian women will be diagnosed with breast cancer [6].

An estimated 4,300 new cases of Spinal Cord Injury occur each year in Canada [7].

4015 Canadian will be diagnosed with Multiple Sclerosis in the next year [8].

165,000 Canadians will have a traumatic brain injury this year [9].

Indirect economic costs due to working-age disability will increase and will be greatest for hospitalized traumatic brain injury (rising from $7.3 billion in 2011 to $8.2 billion in 2031) [10].

Falls are the leading cause of traumatic brain injury (TBI) among seniors [11].

Teens, young adults and seniors are at higher risk of TBI as a pedestrian. Across the life course, the data provided evidence of increased TBI risk among pedestrians leading up to and during the teenage years; risk declined during early adulthood before increasing in middle-age and climbing to high levels among seniors [12].

Female pedestrians have a higher frequency of TBI than males, although the highest risk group is males aged 65 years or older [13].

Brain injury is also identified as a risk factor for Alzheimer’s disease and other dementias in men, and for epilepsy in both sexes [14].

  • Falls are the most frequent reason for TBI hospitalizations and emergency department (ED) visits among children under 5 years of age.
  • Among children and youth aged 5 to 19, sports and recreational activities emerge as a leading cause of TBI-related hospitalizations and ED visits.
  • Assaults are a leading cause of TBI hospitalizations and ED visits among males 20 to 39 years of age.
  • From age 40 years and onward, falls not related to sports and recreation take over as the predominant mechanism of TBI-related deaths, hospitalizations and ED visits, with especially high rates among those 85 years and older [15].

Concussion

Current statistics on concussion are most likely an underestimate of the true burden of concussion. This “invisible injury” is under-reported due to a lack of public education and awareness. Many concussions are seen in doctors’ offices and walk-in clinics, placing them outside of the standard hospital reporting data collection surveillance process; some are ignored and are not reported at all.

Please note: many of these statistics are related to sports

Children & youth
Ice hockey was the most common sports and recreation-related activity with reported concussions or other TBIs among males aged 5 to 14 years. Rugby was the most common for the older males.

Ringette was the most common sports and recreation-related activity with reported concussions or other TBIs among females aged 10 to 19. It is also worth noting that among females in all age groups shown, equestrian sport/horseback riding was also among the most common non-contact sport with reported concussions or other TBIs.

Sledding/tobogganing was among the most common sports and recreation-related activities with reported concussions or other TBIs for children aged 5 to 9 years (3rd most common after ice hockey and physical education class among boys, and 2nd after ice hockey among girls).

All-terrain vehicle (ATV) use was the leading cause of moderate to more severe TBIs (i.e., showed the lowest percentage of concussions among all TBIs) among almost all children and youth, with the exception of females aged 5 to 9 (for whom it was equestrian sport/horseback riding) and males ages 10 to 14 (for whom it was baseball) [16].

In 2013, Hockey Canada implemented a new rule to prohibit body checking in the peewee age group (11 and 12-year-olds) and younger. This change has resulted in a 70% reduction in the risk of concussion, or about 4,800 fewer concussions across Canada [17].

Children under five were the most likely demographic to experience a concussion, followed by women over the age of 65 [18].

The number of physician office or emergency room pediatric visits for concussion-related complaints has quadrupled in Ontario since 2010 [19].

General concussion statistics
There are 200,000 concussions annually in Canada [20].

Sports-related concussion is “among the most complex injuries in sports medicine to diagnose, assess and manage [21].”

There is no single test that can definitively provide a diagnosis of concussion. There is no blood test, no saliva test, no picture test or even no eye-tracking, pupil size or balance test. None exists yet that on its own can objectively diagnose concussion [22].

People living in more remote communities were significantly more likely to experience a concussion than those based in cities, noting rural rates could be as high as 1,400 per 100,000 people [23].


Stroke

General stroke statistics
Stroke is the third leading cause of death in Canada [24].

Stroke is the tenth largest contributor to disability-adjusted life years (the number of years lost due to ill-health, disability or early death) [25].

Stroke predominantly affects older people with about 10% of adults aged 65 years and older having experienced a stroke [26].

The absolute number of people having survived a stroke continues to increase mainly due to population growth and aging [27].

First stroke and all-cause mortality rates have shown a steady decline in recent years. Raised awareness, better stroke care and improvements in the management of risk factors have likely contributed to this decline over several decades [28].

Stroke in women vs. men
The occurrence and rate of first stroke are consistently higher among men than women over time. However, more women than men have a stroke each year, in part because women have a longer life expectancy [29].

The following group of statistics is from the report “Lives disrupted: The impact of stroke on women.”

  • More than 62,000 strokes occur in Canada each year; over 30,200 of these happen to women.
  • One-third more women die of stroke than men in Canada; of all deaths from stroke, 59% are women, 41% are men.
  • Women who have had a stroke have worse outcomes than men; there are more activity limitations and lower overall levels of mental and physical well-being.
  • Women are less likely to go home after stroke; almost twice as many women as men go to long- term care instead.
  • Approximately 405,000 people in Canada are living with the effects of stroke of which 214,000 are women and 191,000 are men.
  • Less than half of stroke survivors who participate in rehabilitation are women (46%), putting them at a disadvantage for making the best recovery possible.
  • Elderly women are particularly over-burdened by stroke and are missing out on access to treatment, care and rehabilitation [30].

Brain tumour & cancer

Tumour statistics
It is estimated that 55,000 Canadians are surviving with a brain tumour.

There are over 120 different types of brain tumours, making effective treatment very complicated.

In the first year after diagnosis, it is estimated the average patient will make 52 visits to their health care team (could include surgery, radiation, chemotherapy, blood work etc.).

Non-malignant tumours account for almost two thirds of all primary brain tumours.

The most common type of primary malignant brain tumour is glioblastoma. Average survival, even with aggressive treatment, is less than one year.

Metastatic brain tumours occur at some point in 20-40% of people with cancer. The incidence of metastatic brain tumours is increasing as cancer patients live longer.

Brain tumours are the leading cause of solid cancer death in children under the age of 20, now surpassing acute lymphoblastic leukemia. They are the third leading cause of solid cancer death in young adults ages 20-39.

Because brain tumours are located at the control centre for thought, emotion, and movement, they can dramatically affect an individual’s physical and cognitive abilities and quality of life [31].

Brain cancer statistics
In 2020, an estimated:

  • 3,000 Canadians will be diagnosed with brain and spinal cord cancer.
  • 2,500 Canadians will die from brain and spinal cord cancer.
  • 1,700 men will be diagnosed with brain and spinal cord cancer and 1,400 will die from it.
  • 1,350 women will be diagnosed with brain and spinal cord cancer and 1,050 will die from it [32].

Hydrocephalus

It is estimated that 120,000 Canadians are living with hydrocephalus. 90% of people with spina bifida, also have hydrocephalus [33].


Caregivers

According to a 2019 study published by the Ontario Caregiver Organization (OCO) and health policy think-tank The Change Foundation, more than half of caregivers admit feeling overwhelmed by their responsibilities. Slightly more than half of the 800-plus caregivers who took part in the study also said they felt anxious or worried, while more than 40% struggled with feelings of frustration [34].

An estimated 8.1 million Canadians aged 15 years and older provided care to a chronically ill, disabled, or aging family member or friend [35].

The following statistics are form the Workplace Mental Health issue brief

•    Over 40% of Canadian physicians report that they are in the advanced stages of burnout.
•    An equal percentage of Canadian nurses reported burnout.
•    14 percent of general nurses have tested positive for symptoms of post-traumatic stress disorder.
•    Healthcare workers are 1.5 times more likely to be off work due to illness or disability than people in all other sectors [36].


Brain injury in the Indigenous community

Indigenous populations are disproportionately affected by traumatic brain injury [37].

Injuries are the leading cause of potential years of life lost in indigenous population, with rates 4 times higher than in the rest of Canada [38].

Aboriginal status appears to be negatively correlated to recovery, with poorer outcomes for Aboriginal people possibly attributable to fewer formal and informal supports, such as professional translators or the loss of social support when a patient relocates away from their home community [39].

The risk of poor outcomes after injury increases, due to factors such as geographical isolation, socioeconomic status, and psychosocial factors, which all already affect the health needs of Aboriginal peoples [40].

A survey of health care practitioners exploring rehabilitation challenges for Aboriginal clients recovering from acquired brain injury (ABI), identified the following areas of interest and concerns that surround Aboriginal communities:

  1. Practitioners’ experience with brain injury;
  2. Practitioners’ experience with Aboriginal clients;
  3. Specialized needs of Aboriginal clients recovering from brain injury;
  4. Culturally sensitive care; and
  5. Traditional healing methods as part of recovery [41].

A key challenge experienced by Aboriginal peoples recovering from ABI was that protocols for rehabilitation and discharge planning are often lacking for clients living on reserves or in remote communities. Other challenges included lack of social support; difficulty of travel and socio-cultural factors associated with post-acute care; and concurrent disorders [42].

The following group of statistics is from the report “Lives disrupted: The impact of stroke on women.”

  • Although the rate of stroke and heart disease has been declining in Canada among most age groups, the opposite is happening in Indigenous populations where prevalence and mortality are increasing. Rates of cardiovascular disease among Indigenous women in Canada are rising and are nearing or surpassing those of non-Indigenous women.
  • First Nations, Métis and Inuit peoples are more likely to have high blood pressure and diabetes – both risk factors for stroke – and are at greater risk of stroke than the general population, and twice as likely to die from it[43]

Incarceration statistics

The incidence of incarceration was higher among study participants with prior traumatic brain injury (TBI) compared with those without a prior TBI. Men and women who had sustained a TBI were about 2.5 times more likely to be incarcerated than men and women who had not sustained a TBI [44].

TBI is more prevalent among males than females in incarcerated populations [45,46] .

Majority of the incarcerated study sample reported having a TBI prior to their first criminal offence  [47,48].

The average age of first TBI was 19.6 years for men and 21.9 for women inmates. 55% of women reported TBI prior to first crime. 41% of men reported TBI prior to first crime [49].


Mental health statistics

In a national population health study of neurological disorders, illness and injury, the highest prevalence of self-reported diagnosed mood disorders was seen in those with a traumatic brain injury (38.3%) or brain tumour (35.5%) [50].

An individual has a significantly greater chance of developing a diagnosable mental illness after sustaining an acquired brain injury (ABI)  [51, 52].

About half of all people with TBI are affected by depression within the first year after injury. Even more (nearly two-thirds) are affected within seven years after injury [53].

Traumatic brain injury is reported to increase the risk of post-traumatic stress symptoms [54].

A Canadian longitudinal cohort study found adults with concussion committed suicide at three times the population norm [55].

50% of patients experience personality change, irritability, anxiety, and depression after concussion. These neuropsychiatric symptoms are not unique, but part of the natural course following concussion [56].


Employment statistics

Indirect economic costs due to working-age disability will increase, however. These costs will be greatest for hospitalized traumatic brain injury (rising from $7.3 billion in 2011 to $8.2 billion in 2031) [57].

The majority of individuals (estimates range from 73-88%) who experience mTBI are able to return to their principal occupation within a year of the injury [58].

TBI’s that occur in the workplace are highly gendered. Serious and fatal injuries occur predominantly among males, however, when all levels of severity are included, women make up more than 40% of injuries [59].

The Ontario Workplace Safety and Insurance Board’s (2016) Statistical Report showed that injuries coded as ‘concussions’ have increased from 0.6% in 2002 to 5% in 2015, indicating an 800% increase [60].

Male workers – especially those in the youngest and oldest age groups – working in the primary (e.g., agriculture, forestry, mining) or construction industries were more likely to sustain a work-related TBI, with falls being the most common mechanism of injury regardless of injury severity [61].


Homelessness and traumatic brain injury statistics

Research shows that over 235,000 people experience homelessness across Canada each year [62].

Approximately 50% of people experiencing homelessness have a brain injury [63].

A recent meta-analysis – which looked at 38 studies published between 1995 and 2018 — is the first to look at the prevalence of TBI in people who are homeless or in unstable housing situations. The results suggest that one in two (53% of) homeless people experience a TBI, and one in four (25%) experience a TBI that is moderate or severe [64].

53% of homeless adults with a history of mental illness have a reported history of brain injury. This population is more likely to:

  • Report unmet health care needs
  • Have contact with the criminal justice system
  • Be suicidal or have previously attempted suicide
  • Use emergency departments
  • Finding housing for people with mental illness and head injuries is essential to helping these people more forward with their recovery [65].

The lifetime prevalence of TBI is high among homeless and marginally housed individuals, and a history of TBI is associated with poorer health and general functioning [66].


Intimate partner violence (IPV) statistics

TBI is common amongst women survivors of intimate partner violence (IPV) [67].

35-80% of women affected by IPV experience symptoms of traumatic brain injury [68].

92% of IPV incidents involving hits to the head and face, and strangulation [69].

It is reported that up to 75% of women do not seek medical care for suspected brain injury [70].

Survivors and care providers can also mistake brain injury symptoms for the emotional distress brought about by the abuse itself [71].

Strangulation is one of the most dangerous forms of IPV, increasing the risk of death in following assaults. These results show non-fatal strangulation as a risk factor in homicide for women, underscoring the need to screen for non-fatal strangulation when assessing abused women in emergency department settings [72].

Strangulation can also cause brain injury, due to the brain being deprived of oxygen. Some victims can die weeks after being strangled because of the underlying brain damage, even if there is no visible injury [73].

Aboriginal women are 3.5 times more likely to experience violence than other Canadian women [74].


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