The rate of traumatic brain injury (TBI) declined 11.4 percent between 1989 and 1998, yet TBI continued to cause an average 53,288 deaths annually. This CDC surveillance summary reports the number of deaths from TBI and identifies trends in deaths related to TBI from 1989 to 1998. Public health and transportation safety officials should continue work to develop injury-prevention programs that provide a multi disciplinary approach to continuing to reduce these deaths. The public should also become full partners in finding and using these solutions.

The decline in TBI-related deaths maybe related to the decline in all types of injury-related deaths, indicating that general injury prevention measures may also influence TBIs. Injury prevention strategies that have demonstrated success include primary enforcement of seat belt and child safety seat laws, graduated licensing of new drivers and community health education campaigns. Additionally, evidence-based guidelines for acute and emergency management of TBI were distributed during this period.

Despite the overall decline, the TBI-related death rate for this period was highest among people 75 years and older.

The three leading causes of TBI death were related to firearms, motor vehicles and falls. Firearm-related TBIs accounted for 40 percent of all TBI deaths, although firearm-related TBI death rates declined by 14 percent in this period; 34 percent were related to motor vehicles, and 10 percent to falls. The leading cause of death differed by age group. Motor vehicles were the leading cause among youth from birth to 19 years of age. Firearm-related TBIs were the leading cause of death among persons aged 20 - 74 years. Fall-related TBIs were the leading cause of death among persons aged 75 and older.

Three times more males than females died from TBI-related causes. However, the rate of death declined by 13 percent among males and 7 percent among females.

TBI-related deaths were highest among American Indian/Alaska Natives with motor-vehicle deaths being the leading cause. The greatest decrease in TBI-related death was among African Americans (20 percent).

Notes to the editor: For the MMWR, please link to this website: http://www.cdc.gov/mmwr. For more information about injuries, visit the CDC's website at: http://www.cdc.gov/ncipc.

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