Parental Report of Significant Head Injuries in Children Aged 3–17 Years: United States, 2016

February 9, 2018

Questions for Lindsey Black, Health Statistician and Lead Author of “Parental Report of Significant Head Injuries in Children Aged 3–17 Years: United States, 2016.”

Q: What was the reason you undertook this research?

LB: Previous research has indicated that the incidence is increasing and much of this trend is being driven by an increase among adolescents. Current incidence of concussions among children is estimated to be 3.5-16.5/1,000. Despite what is known, studies conducted thus far regarding the epidemiology of childhood concussions have either been regional and limited in size, focused on injuries related to sports, dependent on insurance claims, or based on emergency department visits.

There is a lack of a national prevalence and we need to understand the problem outside of the scope of sports injuries. Depending on ED visits are also problematic because evidence is emerging that there is an increasing trend in the use of primary care physicians and specialty clinics as the point of entry into the healthcare system for concussion diagnosis and treatment. Also relying on ED or medical claims will not include non-medically attended concussions.

Further, much research focuses on high school and collegiate athletes and therefore there is not much data on younger children. Despite this, there has been recent recognition for concern and appropriate treatment by the medical community. The goal of this study was to provide a national estimate of parent-reported significant head injuries as well as examine disparities by various demographics and socioeconomic indicators.

Q: What did you find most significant?

LB: There was a steady increase in the percentage of children that had ever had a significant head injury by age group. Although overall boys were more likely than boys to have ever had a significant head injury, the difference was only significant for the 15-17 age group.

Q: Are there any data that look at what sports might be contributing to the number of significant head injuries among children?

LB: Yes, in fact there are many studies that focus on sport related injuries. Our survey and study did not. What sets our study apart is that it was not limited to sports related injuries, so it is going to include a wider range of causes of injuries. Please see “Emergency Department Visits for Concussion in Young Child Athletes” (Bakhos, 2010) and “Epidemiology of Concussion and Mild Traumatic Brain Injury” (Laker 2011) to learn more.

Q: Do you have any insight about whether this percentage who’ve had significant head injuries has increased or declined over time?

LB: Unfortunately we do not have any other historical data on this topic from our survey. At this time, these questions were asked only in 2016 as part of content sponsored by the National Instutite of Health’s National Institute on Deafness and Other Communication Disorders.

Q: Any other points you’d like to make about this study?

LB: We found that about 1 in 10 children in the oldest age group 15-17 had ever had a significant head injury. We also found that overall, boys were more likely than girls to have ever had a significant head injury and there were also disparities by race and parental educational attainment.


QuickStats: Percentage of Children and Teens Aged 6–17 Years Who Missed More Than 10 Days of School in the Past 12 Months Because of Illness or Injury, by Serious Emotional or Behavioral Difficulties Status and Age Group

November 13, 2017

During 2014–2016, children aged 6–17 years whose parent or guardian indicated the child had serious emotional or behavioral difficulties (EBDs) were almost four times as likely to miss more than 10 days of school because of illness or injury compared with children without serious EBDs (13.4% compared with 3.5%).

Among children with serious EBDs, those aged 6–10 years were less likely (8%) to miss more than 10 days of school compared with children aged 11–14 years (15.6%) and children aged 15–17 years (19.5%).

Among children without serious EBDs those aged 15–17 years (4.7%) were more likely to miss >10 school days compared with children aged 6–10 years (3%) and children aged 11–14 years (3.3%).

Source: National Center for Health Statistics. National Health Interview Survey, 2014–2016

QuickStats: Percentage of Children and Teens Aged 5–17 Years Who Missed >10 School Days in the Past 12 Months Because of Illness or Injury, by Sex and Age — National Health Interview Survey, 2013–2015

July 7, 2017


During 2013–2015, 3.9% of boys and 4.3% of girls missed >10 school days in the past 12 months because of illness or injury.

Among children aged 15–17 years, girls were more likely than boys to miss >10 school days (6.8% compared with 3.9%).

Among girls, those aged 15–17 years were more likely than girls aged 5–10 years and girls aged 11–14 years to miss >10 school days (6.8% compared with 3.2% and 4.0%, respectively).

Among boys, there was no difference by age.


Stat of the Day – May 23, 2017

May 23, 2017

Sports and Recreation Related Injury Episodes in the United States, 2011-2014

November 18, 2016
Yahtyng Sheu, Senior Service Fellow

Yahtyng Sheu, Senior Service Fellow

Questions for Yahtyng Sheu, Senior Service Fellow and Lead Author on “Sports and Recreation Related Injury Episodes in the United States, 2011-2014

Q: How many sports and recreation related injuries are being reported annually?

YS: According to our analysis, approximately 8.6 million of sports- and recreation- related injury episodes were reported annually among persons aged 5 and over using data from the 2011-2014 National Health Interview Survey. These injury episodes were medically-attended, for which a health care professional was contacted, either in person or by telephone, for advice or treatment. Therefore, these injury episodes were not limited to those resulted in emergency department visit or hospitalization.

Q: Did the sports and recreation related injuries differ by sex and age group? If so how?

YS: Yes. The distribution of sports- and recreation-related injuries differed by both sex and age. Approximately 60% of all the sports- and recreation-related injuries were sustained by men. Children and young adults between age 5 and 24 years old also accounted for 65% of the total sport- and recreation-related injuries.

Q: What types of sports and recreation activities are causing these injuries?

YS: Our data shows that general exercise, which includes aerobics, exercising, weight training, running, jogging, and school related activity, was the most frequently mentioned activity associated with sports-and recreation-related injuries. However, it does not mean that general exercise is more likely to “cause” injuries. We are unable to study what activities are more likely to cause injuries because the National Health Interview Survey do not collect data on activity participation. This prevents us from evaluating the risk of injury for individual activity.

Q: What parts of the body were more frequently injured while engaging in sports and recreation?

YS: Lower (42%) and upper (30%) extremities were the most frequently mentioned parts of body injured while engaging in the sports and recreation activity.

Q: Why did you decide to look at sports and recreation related injuries?

YS: Many epidemiological studies of sports- and recreation-related injuries have focused on specific populations, sport activities, or outcomes. Limited number of studies have provided national estimates on overall sports- and recreation-related injuries among all population. The latest national estimates on these type of injuries (that are not limited to emergency department visits data) were derived from 1997-1999 data. As more people engage in sports and recreation activity, we feel there is a need to address the patterns of sports- and recreation- related injuries using more recent data.

Injury Mortality: United States, 1999–2014

October 21, 2016

NCHS has released new data visualization that depicts injury mortality in the United States from 1999 through 2014.

This storyboard allows the user to select subcategories of injury deaths based on intent and mechanism of injury.

Numbers and rates are provided for the subcategory selected by the user.

The storyboard includes six dashboards. Deaths can be grouped or separated by mechanism of injury, intent of injury, and selected demographics (sex, age group, race and Hispanic origin).

Drop-down boxes across the top of the dashboard control the display of the entire visualization. The dashboards feature:

Rates: Line charts displaying trends for injury death rates. Both fixed and dynamic scale line charts are provided. The fixed scale line chart allows the user to see changes in rates relative to a predefined y-axis, while the dynamic scale line chart adjusts to maximize the visualization of the trend for the options selected. A dialog box on the left of the dashboard allows the user to select among several options for the range of y-axis values used in the fixed scale line chart.

Numbers of deaths: A table describes numbers of injury deaths for selections made at the top of the visualization.

National Hospital Care Survey Demonstration Projects: Traumatic Brain Injury

July 27, 2016

A new report from NCHS examines traumatic brain injury (TBI) encounters in various hospital settings. While the National Hospital Care Survey (NHCS) data used were not nationally representative, the results presented are consistent with previous research studies.

Analyses were conducted to highlight the tremendous analytical capabilities of NHCS, capabilities that have not been available before in previous surveys. New data elements such as intensive care use and diagnostic and physical services received, and the ability to link individuals in NHCS across hospital settings are used in the analyses.


  • Males have more TBI encounters than females across the inpatient, Emergency Department (ED), and Outpatient Department (OPD) settings and across all age groups.
  • Children under age 15 comprise most ED visits for TBI.
  • Adults aged 65 and over accounted for most TBI hospitalizations.
  • Falls were the most common cause of TBI encounters.