Dear President Obama,
Thank you very much for inviting me to the White House Health Kids and Safe Sports Concussion Summit on May 29, and for hosting this important event.
As you know, a concussion is a brain injury. More significantly, brain injury in youth is the leading public health crisis of our time. However, youth sports-related concussions are the tip of iceberg. Brain injury occurring in youth sports represents less than 40 percent of all brain injuries in American youth. Concussions in sports have received the greatest amount of attention by the media; however, brain injuries can be caused by motor vehicle crashes, child abuse, falls, and gunshots as well as non-traumatic events like strokes, brain tumors, meningitis and seizure disorders.
Brain injury is the number-one leading cause of death and disability for our youth! According to the CDC, over 765,000 American youth enter an emergency room each year with a new brain injury, over 80,000 are hospitalized and over 11,000 die annually. When you compare these numbers with those for HIV/AIDS (approximately 56,000 new cases each year) or autism (approximately 24,000 new cases each year), the staggering incidence rate becomes clear. Basically, every 40 seconds, another American family is entering a hospital with their child suffering from a brain injury.
But these numbers only show a part of the problem.
We know that up to 80 percent of American youth in juvenile detention have a brain injury, more than half of our homeless have a brain injury and over 76 percent of battered women have a brain injury. Recent studies showed that about 40 percent of patients hospitalized for a brain injury suffer from major depression, and that 35 percent had clinically significant levels of hopelessness, 23 percent had suicidal thoughts and 18 percent attempted suicide. It is estimated about 80 million Americans are suffering from some lingering side effects of a previous brain injury (i.e., headaches, sleep disorders, memory issues, lack of concentration).
In order to really tackle this public health crisis, it will take your leadership to involve the many federal departments that have a stake in this issue, including the Departments of Health and Human Services, Education, Veterans Affairs, Defense, Justice, Transportation, Labor and Housing and Urban Development.
The International Advisory Board of the Sarah Jane Brain Foundation has already established the National Pediatric Acquired Brain Injury (PABI) Plan, which develops a seamless, standardized, evidence-based system of care that is universally accessible for the millions of American families with a youth suffering from a brain injury.
As you can see from this letter, a bipartisan group of over members of Congress have recently written to you urging you to implement the PABI Plan. Congress has already authorized and appropriated enough funding across these various federal departments to implement the PABI Plan. All that is left is for you to say, "Yes, we can!"
Youth who sustain brain injuries from sports and other causes are students first and foremost, and the Department of Education should play a major role in the PABI Plan. There are various agencies within HHS that should also play a role, including NIH, CDC, SAMSHA, HRSA and others. With more than 250,000 American veterans returning from war with brain injuries, and with more than half of those being under the age of 25 (the average age of a veteran with traumatic brain injury is about 19 years old), the Departments of Defense and Veterans Affairs should have a significant role in the PABI Plan.
Since motor vehicle crashes account for the highest number of brain injuries in young adults, the Department of Transportation must be involved. As previously noted, the impact that brain injury has within the criminal justice system highlights the need to have the Department of Justice involved. And, any young adults suffering from brain injuries have difficulty transitioning into independent living, hence the need to include the Departments of Labor and HUD.
The PABI Plan already has the support of dozens of national organizations, including the American Academy of Cerebral Palsy and Development Medicine, the American Academy of Pediatrics, the American Academy of Neurology, Iraq and Afghanistan Veterans of America, the American College of Sports Medicine and the National Education Association.
However, this is not just a federal issue. We need to include the private sector, medical institutions and foundations involved in solving this public health crisis, which is why we are proposing to seek private support to implement the PABI Plan by hiring over 5,000 veterans and veterans' family members to serve as the case managers across every state to implement the PABI Plan.
Implementing the PABI Plan will have the largest impact on bending the cost curve of our healthcare expenditures, since many of our expenses from Medicaid and even Medicare go toward treating brain injury.
With your leadership, the PABI Plan will go down as your administration's greatest legacy. It will not only change the lives of millions of American families today but will help us advance our knowledge of the brain faster than any other initiative.
Patrick B. Donohue, J.D., M.B.A.
Founder of the Sarah Jane Brain Foundation
Founder of the International Academy of HOPE (iHOPE)
Father of Sarah Jane Donohue
P.S. The next time you are in New York City, we would like to invite you to visit our school in Central Harlem, the International Academy of HOPE (iHOPE), which is the only school for kids with a brain injury in New York City.