In 1997, there were 9,484 traumatic brain injuries or 117.8 per 100,000 population in New Jersey. This number represents an 11.2% decline in the crude rate compared to the baseline year 1994. Overall, there was a 9.5% decrease in the number of TBIs, compared to 1994 (Table 1). While non-fatal TBIs declined 11.2%, fatalities due to TBI increased by 5.1%. Moreover, the decline in the incidence of non-fatal TBIs is completely accounted for by an apparent decrease in the incidence of mild TBIs; rates for both moderate and severe TBIs increased over the same time period (Figure 1.1). Some of the apparent decline in mild TBI is probably caused by restrictions placed on patient stays by Medicare and insurers. A good number of cases that once required hospitalization may now be treated in outpatient departments leading to a decline in the number and rate of mild injuries. Declining numbers of mild and overall rates of TBI-related hospitalizations are also indicated by outside study which concluded that changes in hospital practices may be a major factor in the decreasing rates of TBI-related hospital admissions; these practices increasingly appear to exclude persons with less severe TBI from hospital admission and shift their care to outpatient settings. ⁶

Although the number and rate of TBI incidents decreased in most demographic groups, and from most external causes, there were some exceptions to the general trend: TBI incidence increased among persons 35 through 44 and 85 and over; self-inflicted TBIs increased slightly. The largest decreases in TBI cases occurred in age groups under 35 years, in TBIs from falls (Figures 1.2-1.4).

TABLE 1: NUMBER OF TRAUMATIC BRAIN INJURIES, RATES AND PERCENT CHANGE BY OUTCOME, SEX, AGE, CAUSE, SEVERITY AND RESIDENCE NEW JERSEY, 1994 AND 1997
Category	Number		Rate per 100,000		% change
	1994	1997	1994	1997	Number	Rate
OVERALL	10,479	9,484	132.6	117.8	-9.5%	-11.2%
OUTCOME
Non-fatal	9,400	8,350	118.9	103.7	-11.2%	-12.8%
Fatal	1,079	1,134	13.7	14.1	+5.1%	+2.9%
SEX
Male	6,688	6,101	174.9	156.1	-8.8%	-10.7%
Female	3,791	3,383	92.9	81.6	-10.8%	-12.2%
AGE GROUP
Under 5	724	544	125.1	97.7	-24.9%	-21.9%
5 -14	1,027	787	97.4	70.4	-23.4%	-27.7%
15 - 24	1,973	1,611	200.3	164.5	-18.3%	-17.9%
25 - 34	1,587	1,290	125.5	110.3	-18.7%	-12.1%
35 - 44	1,224	1,316	94.1	95.0	+7.5%	+1.0%
45 - 54	902	878	93.4	83.2	-2.7%	-10.9%
55 - 64	627	631	92.7	92.4	+0.6%	-0.3%
65 - 74	795	766	129.8	128.4	-3.6%	-1.1%
75 - 84	1,042	975	292.4	252.9	-6.4%	-13.5%
85+	578	686	529.1	554.2	+18.7%	+4.7%
CAUSE
Motor vehicle	3,952	3,838	50.0	47.7	-2.9%	-4.6%
Fall	3,772	3,146	47.7	39.1	-16.6%	-18.0%
Other unintentional	1,223	1,136	15.5	14.1	-7.1%	-9.0%
Self-inflicted	194	198	2.5	2.5	+2.1%	0.0%
Assault	1,154	1,114	14.6	13.8	-3.5%	-5.5%
Other	93	43	1.2	0.5	-53.8%	-58.3%
Unknown	91	9	1.2	0.1	-90.1%	-91.7%
INJURY SEVERITY*
Mild	6,619	5,265	83.7	65.4	-20.5%	-21.9%
Moderate	701	781	8.9	9.7	11.4%	9.0%
Severe	1,816	2,138	23.0	26.5	17.7%	15.2%
Unknown	264	166	3.3	2.1	-37.1%	-36.4%
TOTAL	9,400	8,350	118.9	103.7	-11.2%	-12.8%
RESIDENCE
New Jersey	9,941	8,938	125.8	111.0	-10.1%	-11.8%
Out-of-state	380	408	N/A	N/A	+7.4%	N/A
Unknown	158	138	N/A	N/A	-12.7%	N/A
* Includes only non-fatal hospitalizations.

AGE AND SEX As in 1994, nearly two-thirds of the TBI incidents in 1997 in New Jersey occurred among males (Table 2.1). The male age-adjusted TBI rate remained more than twice the female rate. Among TBI victims aged 75 and over, there were substantially more females than males (Figure 2.1). However, the age-specific rates for TBIs, both fatal and non-fatal, were higher for males in every age group (Table 2.2 and Figures 2.2 and 2.3).

TABLE 2.1: NUMBER OF TRAUMATIC BRAIN INJURIES AND RATES BY AGE AND SEX NEW JERSEY, 1997
AGE GROUP	NUMBER			RATE PER 100,000
	MALE	FEMALE	TOTAL	MALE	FEMALE	TOTAL
Under 5	317	227	544	111.3	83.5	97.7
5-14	542	245	787	94.6	44.9	70.4
15-24	1,189	422	1,611	236.6	88.5	164.5
25-44	1,892	714	2,606	149.8	55.3	102.0
45-64	1,034	475	1,509	123.4	52.8	86.8
65-74	427	339	766	162.9	101.4	128.4
75-84	450	525	975	301.1	222.4	252.9
85+	250	436	686	718.9	489.9	554.2
TOTAL	6,101	3,383	9,484	156.1	81.6	117.8
Percent	64.3%	35.7%	100.0%
Age-adjusted rate based on all occurrences-1997				153.2	67.9	110.2
1994				174.8	81.6	127.7
% change 1994-1997				-12.4%	-16.8%	-13.7%
Age-adjusted rate based on resident occurrences-1997				144.1	63.9	103.7
1994				165.1	77.8	121.0
% change 1994-1997				-12.7%	-17.9%	-14.3%

TABLE 2.2: NUMBER OF TRAUMATIC BRAIN INJURIES AND RATES BY AGE, OUTCOME AND SEX NEW JERSEY, 1997
	FATAL
AGE GROUP	NUMBER			RATE PER 100,000
	MALE	FEMALE	TOTAL	MALE	FEMALE	TOTAL
Under 5	11	10	21	3.9	3.7	3.8
5-14	24	10	34	4.2	1.8	3.0
15-24	122	39	161	24.3	8.2	16.4
25-44	207	62	269	16.4	4.8	10.5
45-64	166	47	213	19.8	5.2	12.3
65-74	81	36	117	30.9	10.8	19.6
75-84	109	77	186	72.9	32.6	48.2
85+	59	74	133	169.7	83.1	107.5
TOTAL	779	355	1,134	19.9	8.6	14.1
Percent	68.7%	31.3%	100.0%
Age-adjusted based on all occurrences-1997				17.6	5.9	11.5
1994				17.8	5.5	11.3
% change 1994-1997				-1.1%	+7.3%	+1.8%
Age-adjusted rate for New Jersey resident population-1997				16.7	5.6	11.0
1994				16.3	5.0	10.3
% change 1994-1997				+2.5%	+12.0%	+6.8%
	NON-FATAL
AGE GROUP	NUMBER			RATE PER 100,000
	MALE	FEMALE	TOTAL	MALE	FEMALE	TOTAL
Under 5	306	217	523	107.4	79.8	93.9
5-14	518	235	753	90.4	43.1	67.3
15-24	1,067	383	1,450	212.4	80.3	148.1
25-44	1,685	652	2,337	133.4	50.5	91.5
45-64	868	428	1,296	103.6	47.5	74.6
65-74	346	303	649	132.0	90.6	108.8
75-84	341	448	789	228.2	189.8	204.7
85+	191	362	553	549.3	406.7	446.8
TOTAL	5,322	3,028	8,350	136.2	73.1	103.7
Percent	63.7%	36.3%	100.0%
Age-adjusted rate based on New Jersey occurrences - 1997				135.6	62.0	98.6
1994				157.0	76.1	116.4
% change				-13.6%	-18.5%	-15.3%
Age-adjusted rate for New Jersey resident population - 1997				127.4	58.3	92.7
1994				148.8	72.8	110.7
% change 1994-1997				-14.4%	-19.9%	-16.3%

AGE, SEVERITY AND OUTCOME More than half of the TBIs in New Jersey were mild non-fatal and fewer than 10% were of non-fatal moderate severity (Table 1 and Table 2.3). The greatest frequency of non-fatal mild and moderate TBIs occurred among persons 15 through 44 years of age. More than 20% of the TBIs were severe but not fatal. The higher rates for these cases by far were in the 75 and over population. Half of the hospitalized fatalities related to TBI were of persons 65 and over, whereas this group accounted for only 29% of the non-hospitalized fatalities. The highest rates of TBI regardless of severity were in the population 85 and over (Table 2.3 and Figure 2.4). Rates in all of these categories were particularly high in persons 75 through 84 years also. Other than the elderly population (65 years and over), the highest rates in each severity and fatality site were in the young population, 15 through 24 years, and this group had the second highest rate of mild TBIs. Of TBIs occurring in females, the percent that were mild was somewhat higher than the percent of TBIs that were mild in males, even though the number of TBIs and total in males was higher than in females (Figure 2.5).

TABLE 2.3: NUMBER OF TRAUMATIC BRAIN INJURIES AND RATES BY AGE, OUTCOME AND SEVERITY NEW JERSEY, 1997
AGE GROUP	NON-FATAL			FATAL		TOTAL
	MILD	MODER- ATE	SEVERE	HOSPI- TALIZED	NON- HOSPI- TALIZED
Under 5	316	56	139	14	7	544
5-14	537	67	130	17	17	787
15-24	1,030	129	273	54	107	1,611
25-44	1,569	232	496	87	182	2,606
45-64	811	116	350	78	135	1,509
65-74	349	71	217	60	57	766
75-84	378	69	322	109	77	975
85+	275	41	211	80	53	686
TOTAL	5,265	781	2,138	499	635	9,484
Percent	55.5%	8.2%	22.5%	5.3%	6.7%	100.0%
AGE GROUP	NON-FATAL RATE PER 100,000			FATAL RATE PER 100,000		TOTAL RATE PER 100,000
	MILD	MODER- ATE	SEVERE	HOSPI- TALIZED	NON- HOSPI- TALIZED
Under 5	56.7	10.1	25.0	2.5	1.3	97.7
5-14	48.0	6.0	11.6	1.5	1.5	70.4
15-24	105.2	13.2	27.9	5.5	10.9	164.5
25-44	61.4	9.1	19.4	3.4	7.1	102.0
45-64	46.7	6.7	20.1	4.5	7.8	86.8
65-74	58.5	11.9	36.4	10.1	9.6	128.4
75-84	98.1	17.9	83.5	28.3	20.0	252.9
85+	222.2	33.1	170.5	64.6	42.8	554.2
TOTAL	65.4	9.7	26.5	6.2	7.9	117.8
Note 1.Mild (ICD/AIS=1 or 2) 2.Moderate (ICD/AIS = 3) 3.Severe (ICD/AIS= 4 - 6) 4.Total includes unknown levels of severity

AGE, OUTCOME AND CAUSE The major external causes of TBI in 1997 in New Jersey were motor vehicle injuries and falls (Table 3A). The largest numbers of motor vehicle-related fatalities and non-fatal TBI incidents occurred among the population 15 through 44 years. The greatest frequencies of TBIs from falls were in the population 75 and over. Self-inflicted TBIs were highest in 25 through 64 year olds and TBIs from assaults occurred in highest numbers among 15 though 44 year olds (Table 3A). Despite the higher number of TBI-related fatalities from motor vehicle-related causes in the younger population, the rates of these fatalities were highest in the ages 75 and over population, as were TBI fatalities from falls, other unintentional causes and self-inflicted injuries (Table 3B and Figure 3). The rate of self-inflicted TBI-related fatalities in the 45-64 years was also relatively high, and the assault rate in 15 through 24 year olds was higher than in any other age group. Rates of non-fatal TBIs related to the use of motor vehicles were much higher among persons aged 15 through 24 year olds than among other age groups. The rate of non-fatal TBI caused by assault was also substantially elevated among adolescents and young adults. Persons 75 and over had the highest rates of non-fatal TBI from falls and other unintentional injuries, and had the highest non-fatal TBI rates from all causes (Table 3B).

TABLE 3A: TRAUMATIC BRAIN INJURIES BY AGE, OUTCOME AND CAUSE NEW JERSEY, 1997
FATAL
Age group	Motor Vehicle	Fall	Other uninten- tional	Self inflicted	Assault	Other/ Unknown	All Causes
Under 5	11	2	5	0	3	0	21
5 -14	21	4	4	0	4	1	34
15 - 24	80	5	12	17	43	4	161
25 - 44	99	23	36	51	57	3	269
45 - 64	56	49	23	59	23	3	213
65 - 74	27	50	21	14	4	1	117
75 - 84	35	83	48	17	1	2	186
85 +	20	69	37	4	3	0	133
TOTAL	349	285	186	162	138	14	1,134
PERCENT	30.8%	25.1%	16.4%	14.3%	12.2%	1.2%	100.0%
NON-FATAL
Age group	Motor Vehicle	Fall	Other uninten- tional	Self inflicted	Assault	Other/ Unknown	All Causes
Under 5	86	349	53	0	30	5	523
5 -14	303	215	193	2	38	2	753
15 - 24	868	165	173	7	234	3	1,450
25 - 44	1,190	387	218	17	510	15	2,337
45 - 64	599	418	136	6	132	5	1,296
65 - 74	228	340	60	2	15	4	649
75 - 84	173	522	82	1	9	2	789
85 +	42	465	35	1	8	2	553
TOTAL	3,489	2,861	950	36	976	38	8,350
PERCENT	41.8%	34.3%	11.4%	0.4%	11.7%	0.4%	100.0%
TOTAL
Age group	Motor Vehicle	Fall	Other uninten- tional	Self inflicted	Assault	Other/ Unknown	All Causes
Under 5	97	351	58	0	33	5	544
5 -14	324	219	197	2	42	3	787
15 - 24	948	170	185	24	277	7	1,611
25 - 44	1,289	410	254	68	567	18	2,606
45 - 64	655	467	159	65	155	8	1,509
65 - 74	255	390	81	16	19	5	766
75 - 84	208	605	130	18	10	4	975
85 +	62	534	72	5	11	2	686
TOTAL	3,838	3,146	1,136	198	1,114	52	9,484
PERCENT	40.5%	33.2%	12.0%	2.1%	11.7%	0.5%	100.0%

TABLE 3B: TRAUMATIC BRAIN INJURY RATES BY AGE, OUTCOME AND CAUSE NEW JERSEY, 1997
FATAL RATE PER 100,000
Age group	Motor Vehicle	Fall	Other uninten- tional	Self inflicted	Assault	Other/ Unknown	All Causes
Under 5	2.0	0.4	0.9	0.0	0.5	0.0	3.8
5 -14	1.8	0.4	0.4	0.0	0.4	0.0	3.0
15 - 24	8.2	0.5	1.2	1.7	4.4	0.4	16.4
25 - 44	3.9	0.9	1.4	2.0	2.2	0.1	10.5
45 - 64	3.2	2.8	1.3	3.4	1.3	0.2	12.3
65 - 74	4.5	8.4	3.5	2.3	0.7	0.2	19.6
75 - 84	9.1	21.5	12.5	4.4	0.3	0.4	48.2
85 +	16.2	55.7	29.9	3.2	2.4	0.0	107.5
TOTAL	4.3	3.5	2.3	2.0	1.7	0.2	14.1
NON-FATAL RATE PER 100,000
Age group	Motor Vehicle	Fall	Other uninten- tional	Self inflicted	Assault	Other/ Unknown	All Causes
Under 5	15.4	62.7	9.5	0.0	5.4	0.9	93.9
5 -14	27.1	19.2	17.3	0.2	3.4	0.2	67.3
15 - 24	88.6	16.8	17.7	0.7	23.9	0.3	148.1
25 - 44	46.6	15.1	8.5	0.7	20.0	0.6	91.5
45 - 64	34.5	24.0	7.8	0.3	7.6	0.3	74.6
65 - 74	38.2	57.0	10.1	0.3	2.5	0.7	108.8
75 - 84	44.9	135.4	21.3	0.3	2.3	0.5	204.7
85 +	33.9	375.7	28.3	0.8	6.5	1.6	446.8
TOTAL	43.3	35.5	11.8	0.4	12.1	0.5	103.7
TOTAL RATE PER 100,000
Age group	Motor Vehicle	Fall	Other uninten- tional	Self inflicted	Assault	Other/ Unknown	All Causes
Under 5	17.4	63.0	10.4	0.0	5.9	0.9	97.7
5 -14	29.0	19.6	17.6	0.2	3.8	0.2	70.4
15 - 24	96.8	17.4	18.9	2.5	28.3	0.7	164.5
25 - 44	50.5	16.0	9.9	2.7	22.2	0.7	102.0
45 - 64	37.7	26.9	9.1	3.7	8.9	0.5	86.8
65 - 74	42.8	65.4	13.6	2.7	3.2	0.8	128.4
75 - 84	54.0	156.9	33.7	4.7	2.6	0.9	252.9
85 +	50.1	431.4	58.2	4.0	8.9	1.6	554.2
TOTAL	47.7	39.1	14.1	2.5	13.8	0.6	117.8

FIREARM-RELATED TRAUMATIC BRAIN INJURIES There were 290 TBIs in 1997 that involved the use of firearms (Table 4). This number was unchanged from 1994. Of these, 90.0% were fatal and 78.6 percent died prior to receiving acute care treatment. The vast majority of the firearm victims were male, almost all of these TBI injuries were intentional (the majority being self-inflicted), and most occurred among persons aged 15 through 64 years.

TABLE 4: FIREARM-RELATED TRAUMATIC BRAIN INJURIES BY AGE, SEX, INTENT AND OUTCOME NEW JERSEY, 1997
CATEGORY AGE GROUP	FATAL		NON-FATAL		TOTAL
	Number	Percent	Number	Percent	Number	Percent
AGE GROUP
Under 15	4	1.5%	2	6.9%	6	2.0%
15 - 24	58	22.2%	6	20.7%	64	22.1%
25 - 44	86	33.0%	12	41.4%	98	33.8%
45 - 64	73	28.0%	8	27.6%	81	27.9%
65 - 74	19	7.3%	1	3.4%	20	6.9%
75 - 84	17	6.5%	0	0.0%	17	5.9%
85 +	4	1.5%	0	0.0%	4	1.4%
TOTAL	261	100.0%	29	100.0%	290	100.0%
SEX:
Male	232	88.9%	23	79.3%	255	87.9%
Female	29	11.1%	6	20.7%.	35	12.1%
TOTAL	261	100.0%	29	100.0%	290	100.0%
INTENTION:
Unintentional	8	3.1%	3	10.3%	11	3.8%
Self-inflicted	164	62.8%	8	27.6%	172	59.3%
Assault	85	32.6%	13	44.8%	98	33.8%
Undetermined	4	1.5%	5	17.2%	9	3.1%
TOTAL	261	100.0%	29	100.0%	290	100.0%

DISPOSITION Almost 7% of the TBI victims in New Jersey in 1997 died prior to being treated and another 5% died after admission to an acute care hospital. Most (70%) were discharged to home after hospital treatment and 16% were discharged to continued treatment in another acute care facility, rehabilitation center or nursing home (data not shown). HOSPITALIZATION CHARGES In 1997, total TBI-related hospitalization charges in New Jersey were in excess of 180 million dollars for 61,753 inpatient care days. This excludes physician, rehabilitation and other costs. Private insurance/HMOs were the expected source of payment for almost half of the inpatient stays (Table 5). The next most frequent expected source of payment was governmental sources (Medicaid, Medicare, etc.) which accounted for almost one-fourth of the hospital charges. The average TBI-related hospitalization charges were $20,347 for a mean length of stay of 7.0 days. The charges were greater for those with a severe TBI with average charges of $38,113 for 12.7 days of inpatient care. Using a national estimate7, the approximate costs of treatment and rehabilitation of severe TBIs that occurred in New Jersey in 1997 translate to approximately 800 million dollars.

TABLE 5: TRAUMATIC BRAIN INJURY-RELATED ACUTE CARE CHARGES AND IN-PATIENT CARE DAYS BY EXPECTED PRIMARY PAYER NEW JERSEY, 1997
Expected Primary payer	Number	Percent	Average charges per hospitalization	Mean length of stay (days)
Insurance/HMO	4,286	48.4%	$24,236	6.9
Self-pay	2,180	24.6%	$13,356	4.4
Medicare	1,641	18.5%	$18,803	10.7
Medicaid	345	3.9%	$21,174	7.3
Workers comp.	337	3.8%	$24,452	6.5
Other government	60	0.7%	$10,962	5.0
TOTAL	8,849	100.0%	$20,347	7.0

COUNTY OF RESIDENCE AT THE TIME OF HOSPITALIZATION/DEATH The age-adjusted TBI incidence rate declined between 1994 and 1997 in almost all counties (Table 6.1). In the only exceptions to this trend, the age-adjusted rates in Essex and Mercer Counties increased slightly. Morris and Hunterdon Counties had the lowest rates in both time periods. Hudson County had the highest number and rate of TBIs in the state in 1997. However, Atlantic County had the highest rate of TBI-related fatalities (Table 6.2). Particularly high rates of TBI hospitalization persisted between 1994 and 1997 among residents of Hudson County, which alone accounted for over 12% of all hospitalized non-fatal TBIs occurring in the state in 1997. Other counties with disproportionately elevated non-fatal TBI rates as of 1997 include Atlantic, Camden, Cumberland, and Passaic Counties (Table 6.2). The highly disproportionate rate of TBI was present among both males and females (Table 6.3). TBI rates were also particularly elevated among males in Essex County, and among females in Monmouth County.

TABLE 6.1: NUMBER OF TRAUMATIC BRAIN INJURIES AND CRUDE AND AGE-ADJUSTED RATES BY COUNTY OF RESIDENCE NEW JERSEY, 1994 AND 1997
County of Residence	1994			1997
	Number	Crude Rate per 100,000	Age-adjusted rate per 100,000	Number	Crude Rate per 100,000	Age-adjusted rate per 100,000
Atlantic	482	207.6	201.5	328	138.6	134.7
Bergen	896	106.4	96.6	822	96.6	84.0
Burlington	356	89.3	87.8	318	76.1	71.4
Camden	866	170.9	170.5	748	148.2	144.2
Cape May	146	149.3	143.7	107	109.0	88.4
Cumberland	251	180.8	180.0	200	141.9	137.5
Essex	966	126.2	118.8	944	125.7	120.5
Gloucester	269	111.4	113.8	243	98.8	90.5
Hudson	1,137	205.8	200.6	1,140	206.7	196.1
Hunterdon	74	64.2	67.0	83	68.8	62.6
Mercer	374	113.5	107.6	397	120.4	108.7
Middlesex	683	98.6	94.6	576	81.3	76.5
Monmouth	682	117.9	117.9	687	115.2	111.9
Morris	327	74.6	70.7	313	68.9	63.9
Ocean	532	116.5	113.7	472	98.2	92.6
Passaic	815	176.5	168.6	655	135.3	129.0
Salem	102	157.4	151.1	62	93.9	92.0
Somerset	227	87.1	89.0	218	78.7	75.2
Sussex	145	104.9	112.8	139	97.8	101.3
Union	518	104.4	92.5	405	81.3	68.6
Warren	93	97.5	93.4	81	82.4	74.3
TOTAL-NEW JERSEY	9,941	125.8	121.0	8,938	111.0	103.7
Out-of-state	380	N/A	N/A	408	N/A	N/A
Unknown	158	N/A	N/A	138	N/A	N/A
TOTAL OCCURRENCES	10,479	N/A	N/A	9,484	N/A	N/A
Note: 1940 standard populations were used to compute age-adjusted rates.

TABLE 6.2: NUMBER OF TRAUMATIC BRAIN INJURIES AND CRUDE AND AGE-ADJUSTED RATES BY COUNTY OF RESIDENCE AND OUTCOME NEW JERSEY, 1997
COUNTY OF RESIDENCE	Fatal			NON-FATAL
	Number	Crude Rate per 100,000	Age-adjusted Rate per 100,000	Number	Crude Rate per 100,000	Age-adjusted rate per 100,000
Atlantic	52	22.0	20.2	276	116.7	114.5
Bergen	81	9.5	6.6	741	87.0	77.3
Burlington	57	13.6	11.5	261	62.5	59.9
Camden	89	17.6	16.8	659	130.6	127.4
Cape May	18	18.3	12.8	89	90.7	75.7
Cumberland	28	19.9	15.4	172	122.1	122.2
Essex	131	17.4	16.7	813	108.3	103.9
Gloucester	37	15.0	12.6	206	83.7	77.9
Hudson	92	16.7	13.3	1,048	190.0	182.8
Hunterdon	10	8.3	7.0	73	60.5	55.5
Mercer	44	13.3	11.5	353	107.0	97.2
Middlesex	60	8.5	6.5	516	72.9	70.0
Monmouth	78	13.1	11.6	609	102.1	100.4
Morris	35	7.7	5.4	278	61.2	58.5
Ocean	76	15.8	12.5	396	82.4	80.1
Passaic	49	10.1	8.3	606	125.2	120.7
Salem	10	15.1	16.6	52	78.7	75.4
Somerset	33	11.9	8.2	185	66.8	67.0
Sussex	16	11.3	12.1	123	86.6	89.1
Union	77	15.5	8.9	328	65.8	59.7
Warren	7	7.1	6.9	74	75.3	67.4
Total-New Jersey	1,080	13.4	11.0	7,858	97.6	92.7
Out-of-state	53	N/A	N/A	355	N/A	N/A
Unknown	1	N/A	N/A	137	N/A	N/A
TOTAL	1,134	14.1	11.0	8,350	103.7	98.6
Note: 1940 standard populations were used to compute age-adjusted rates.

TABLE 6.3: NUMBER OF TRAUMATIC BRAIN INJURIES AND CRUDE AND AGE-ADJUSTED RATES BY COUNTY OF RESIDENCE AND SEX NEW JERSEY, 1997
COUNTY OF RESIDENCE	MALE			FEMALE
	Number	Crude Rate per 100,000	Age-adjusted Rate per 100,000	Number	Crude Rate per 100,000	Age-adjusted rate per 100,000
Atlantic	217	190.0	190.9	111	90.7	79.6
Bergen	476	116.2	109.3	346	78.3	59.3
Burlington	194	93.7	90.6	124	58.8	52.9
Camden	502	205.9	207.3	246	94.3	83.4
Cape May	60	126.9	116.7	47	92.5	59.4
Cumberland	136	195.5	194.8	64	89.7	80.8
Essex	652	183.1	182.4	292	74.0	61.1
Gloucester	153	127.1	122.0	90	71.6	60.9
Hudson	788	294.7	287.5	352	123.9	107.0
Hunterdon	53	87.6	81.3	30	49.9	45.2
Mercer	257	160.6	155.4	140	82.5	61.8
Middlesex	368	105.3	104.1	208	58.0	49.0
Monmouth	388	134.0	138.9	299	97.5	84.3
Morris	213	95.7	93.2	100	43.2	36.2
Ocean	286	125.2	123.7	186	73.7	62.3
Passaic	431	183.7	182.7	224	89.8	76.0
Salem	39	121.6	126.1	23	67.7	57.8
Somerset	135	98.9	96.9	83	59.1	55.1
Sussex	96	135.3	152.2	43	60.5	48.3
Union	246	102.6	94.1	159	61.5	44.1
Warren	45	94.0	92.2	36	71.4	56.5
Total-New Jersey	5,735	146.8	144.1	3,203	77.3	63.9
Out-of-state	277	N/A	N/A	131	N/A	N/A
Unknown	89	N/A	N/A	49	N/A	N/A
TOTAL OCCURRENCES	6,101	N/A	156.1	3,383	81.6	67.9
Note: 1940 standard populations were used to compute age-adjusted rates.

TABLE 6.4A: NUMBER OF TRAUMATIC BRAIN INJURIES BY COUNTY OF RESIDENCE AND CAUSE NEW JERSEY, 1997
COUNTY OF RESIDENCE	Motor Vehicle	Fall	Other uninten-tional	Assault	Self-inflicted	Other/ Unknown	All Causes
Atlantic	178	83	25	31	10	1	328
Bergen	296	284	173	52	14	3	822
Burlington	146	100	26	24	19	3	318
Camden	349	202	50	121	20	6	748
Cape May	38	50	13	5	1	0	107
Cumberland	100	56	16	22	5	1	200
Essex	322	324	84	192	19	3	944
Gloucester	111	67	40	17	8	0	243
Hudson	351	409	102	258	11	9	1,140
Hunterdon	35	36	9	0	2	1	83
Mercer	168	124	36	63	4	2	397
Middlesex	257	217	57	36	7	2	576
Monmouth	298	215	113	46	11	4	687
Morris	99	129	65	15	5	0	313
Ocean	228	139	80	10	11	4	472
Passaic	213	231	50	137	20	4	655
Salem	32	16	6	6	2	0	62
Somerset	93	83	24	9	8	1	218
Sussex	46	55	31	5	2	0	139
Union	146	168	49	32	6	4	405
Warren	25	35	10	5	3	3	81
Total-New Jersey	3,531	3,023	1,059	1,086	188	51	8,938
Out-of-state	232	91	52	25	8	0	408
Unknown	75	32	25	3	2	1	138
TOTAL OCCURRENCES	3,838	3,146	1,136	1,114	198	52	9,484

COUNTY OF RESIDENCE AND CAUSE The four counties with the highest rates of TBI related to motor vehicle incidents were Atlantic, Camden, Cumberland, and Hudson. Together, these four counties accounted for more than one-fourth of all motor vehicle-related TBIs (Table 6.4A). Hudson and Camden Counties, along with Essex and Passaic Counties, also had disproportionately high rates of TBI related to falls and assaults. Together, these four counties accounted for well over one-third of fall-related TBIs, and nearly two-thirds of assault-related TBIs. Hudson County, which had particularly elevated TBI rates in all categories (Table 6.4B), alone accounted for nearly 10% of all motor vehicle-related TBIs, 13% of all fall-related TBIs, and 23% of all assault-related TBIs (Table 6.4A).

TABLE 6.4B: TRAUMATIC BRAIN INJURY RATES BY COUNTY OF RESIDENCE AND MAJOR CAUSE NEW JERSEY, 1997
COUNTY OF RESIDENCE	Motor Vehicle		Fall		Assault
	Crude rate per 100,000	AGE-ADJUSTED RATE PER 100,000	Crude rate per 100,000	AGE-ADJUSTED RATE PER 100,000	CRUDE RATE PER 100,000	Age-adjusted Rate per 100,000
Atlantic	75.2	78.2	35.1	25.7	13.1	14.7
Bergen	34.8	36.7	33.4	20.2	6.1	7.6
Burlington	34.9	36.4	23.9	18.1	5.7	6.2
Camden	69.2	71.0	40.0	31.7	24.0	26.2
Cape May	38.7	46.1	51.0	25.9	5.1	6.5
Cumberland	71.0	76.3	39.7	28.7	15.6	17.2
Essex	42.9	45.5	43.2	33.8	25.6	27.4
Gloucester	45.1	47.8	27.2	18.6	6.9	7.8
Hudson	63.7	66.6	74.2	60.2	46.8	48.4
Hunterdon	29.0	30.0	29.9	22.2	0.0	0.0
Mercer	50.9	52.9	37.6	24.8	19.1	18.9
Middlesex	36.3	36.7	30.6	25.4	5.1	5.2
Monmouth	50.0	55.8	36.1	26.7	7.7	9.0
Morris	21.8	22.5	28.4	22.6	3.3	3.8
Ocean	47.4	53.3	28.9	17.1	2.1	3.0
Passaic	44.0	46.4	47.7	38.5	28.3	28.7
Salem	48.5	54.6	24.2	17.3	9.1	7.9
Somerset	33.6	36.1	30.0	23.2	3.3	3.7
Sussex	32.4	40.3	38.7	31.5	3.5	4.4
Union	29.3	29.7	33.7	21.1	6.4	7.1
Warren	25.4	27.8	35.6	23.2	5.1	6.8
Total-New Jersey	43.8	46.2	37.5	27.5	13.5	14.7
Note: 1940 standard populations were used to compute age-adjusted rates.

TABLE 6.5A: TRAUMATIC BRAIN INJURIES BY COUNTY OF RESIDENCE AND AGE NEW JERSEY, 1997
COUNTY OF RESIDENCE	Under 15	15-24	25-44	45-64	65-74	75+	TOTAL
Atlantic	34	72	110	44	25	43	328
Bergen	85	118	194	134	69	222	822
Burlington	45	61	70	60	22	60	318
Camden	118	125	229	131	50	95	748
Cape May	5	16	28	13	6	39	107
Cumberland	21	46	49	36	16	32	200
Essex	155	179	276	133	76	125	944
Gloucester	35	43	60	33	20	52	243
Hudson	188	184	366	174	75	153	1,140
Hunterdon	11	7	20	16	8	21	83
Mercer	47	69	125	54	33	69	397
Middlesex	103	97	126	98	55	97	576
Monmouth	101	131	179	104	56	116	687
Morris	47	46	67	49	36	68	313
Ocean	61	70	118	68	43	112	472
Passaic	94	117	203	113	47	81	655
Salem	6	11	23	7	6	9	62
Somerset	31	35	51	37	24	40	218
Sussex	25	33	23	21	9	28	139
Union	51	52	90	61	39	112	405
Warren	15	14	8	13	8	23	81
Total-New Jersey	1,278	1,526	2,415	1,399	723	1,597	8,938
Out-of-state	30	67	144	78	30	59	408
Unknown	23	18	47	32	13	5	138
TOTAL OCCURRENCES	1,331	1,611	2,606	1,509	766	1,661	9,484

TABLE 6.5B: TRAUMATIC BRAIN INJURY RATES BY COUNTY OF RESIDENCE AND AGE NEW JERSEY, 1997
	Age-specific rate per 100,000
COUNTY OF RESIDENCE	UNDER 15	15-24	25-44	45-64	65-74	75+	TOTAL
Atlantic	69.3	243.5	148.1	91.6	135.2	251.0	138.6
Bergen	55.6	128.1	73.8	63.9	96.3	357.7	96.6
Burlington	48.2	115.7	51.7	66.4	82.9	309.3	76.1
Camden	97.2	203.4	145.4	130.0	142.5	335.6	148.2
Cape May	25.3	160.2	104.8	62.4	55.5	390.5	109.0
Cumberland	64.1	253.7	115.6	127.4	154.0	357.6	141.9
Essex	97.0	178.5	115.8	85.7	146.5	275.2	125.7
Gloucester	58.8	139.2	76.4	66.7	125.0	449.3	98.8
Hudson	173.5	252.0	198.1	152.9	190.3	476.0	206.7
Hunterdon	42.7	54.9	48.1	55.9	128.2	375.0	68.8
Mercer	70.5	151.1	120.1	77.9	136.6	346.2	120.4
Middlesex	74.6	99.7	52.8	65.4	109.8	282.2	81.3
Monmouth	78.5	196.1	94.6	78.7	136.1	304.7	115.2
Morris	51.7	85.6	45.2	43.8	136.9	294.0	68.9
Ocean	62.7	147.0	92.4	74.6	73.9	190.5	98.2
Passaic	88.3	178.0	132.9	115.0	146.8	281.5	135.3
Salem	40.1	141.2	121.7	48.9	109.6	195.1	93.9
Somerset	56.8	120.1	52.3	57.0	139.6	297.6	78.7
Sussex	70.7	211.5	46.6	73.6	133.7	430.9	97.8
Union	52.5	89.4	58.0	54.6	94.2	323.3	81.3
Warren	68.4	130.3	25.7	62.1	111.5	356.2	82.4
Total-New Jersey	76.3	155.8	94.5	80.5	121.2	313.6	111.0

TABLE 6.6: NUMBER OF TRAUMATIC BRAIN INJURIES AND RATES BY COUNTY OF RESIDENCE AND SEVERITY NEW JERSEY, 1997
	NUMBER				RATE PER 100,000
COUNTY OF RESIDENCE	Mild	Moderate to severe	Fatal	Total*	Mild	Moderate to severe	Fatal	Total*
Atlantic	187	76	52	328	79.0	36.8	21.9	138.6
Bergen	480	220	81	822	56.4	30.1	9.5	96.6
Burlington	170	78	57	318	40.7	20.8	13.6	76.1
Camden	394	231	89	748	78.1	50.9	17.6	148.2
Cape May	57	26	18	107	58.1	31.6	18.3	109.0
Cumberland	108	52	28	200	79.5	41.1	19.9	142.0
Essex	419	307	131	944	76.6	49.1	17.5	125.8
Gloucester	130	64	37	243	55.8	30.4	15.0	98.7
Hudson	814	176	92	1,140	147.6	40.1	16.6	206.7
Hunterdon	36	27	10	83	29.9	28.2	8.3	68.9
Mercer	226	104	44	397	68.5	37.0	13.4	120.4
Middlesex	288	188	60	576	40.7	31.4	8.5	81.3
Monmouth	422	149	78	687	70.8	30.1	13.1	115.2
Morris	160	90	35	313	35.2	23.3	7.7	68.9
Ocean	247	123	76	472	51.4	29.5	15.8	98.2
Passaic	395	170	49	655	81.6	35.1	10.1	135.2
Salem	27	21	10	62	40.9	37.9	15.1	93.8
Somerset	106	66	33	218	38.3	26.0	11.9	78.8
Sussex	66	44	16	139	46.5	39.5	11.3	97.9
Union	171	123	77	405	34.3	30.9	15.4	81.3
Warren	47	21	7	81	47.8	24.4	7.2	82.5
TOTAL-NJ	4,950	1,966	1,080	8,938	61.5	34.1	13.4	111.0
Out-of-state	232	103	53	408	N/A	N/A	N/A	N/A
Unknown	102	27	1	138	N/A	N/A	N/A	N/A
TOTAL OCCURENCES	5,621	2,309	1,134	9,484	N/A	N/A	N/A	N/A
* Includes unknown levels of severity

TABLE 7A: TRAUMATIC BRAIN INJURIES IN SELECTED URBAN AREAS NEW JERSEY, 1997
City	County	Number of TBIs	% of county total	City rate per 100,0000	County rate per 100,000	Trauma care level
Atlantic City	Atlantic	72	22.0%	188.7	138.6	II
Camden City	Camden	312	41.7%	371.0	148.2	I
Jersey City	Hudson	706	61.9%	306.0	206.7	II
Newark	Essex	467	49.5%	174.8	125.7	I
Paterson	Passaic	333	50.8%	224.4	135.3	II
Trenton	Mercer	249	62.7%	293.8	120.4	II
TOTAL		2,139	50.8%	250.7	147.4
Note: TBI incidencts occurring in some neighboring towns may have been counted in the city total. Caution should be used in interpreating these results.

TABLE 7B: TRAUMATIC BRAIN INJURY RATES IN SELECTED URBAN AREAS BY MAJOR CAUSE NEW JERSEY, 1997
		Rate per 100,000
CITY	COUNTY	Motor vehicle	Fall	Assault	Other	Total
ATLANTIC CITY	ATLANTIC	86.6	57.6	28.8	15.7	188.7
Camden City	Camden	184.3	72.5	92.8	21.4	371.0
Jersey City	Hudson	92.8	99.3	85.8	28.1	306.0
Newark	Essex	59.2	50.9	47.9	16.8	174.8
Paterson	Passaic	74.2	66.0	66.0	18.2	224.4
Trenton	Mercer	135.7	75.5	62.5	20.1	293.8
TOTAL		92.0	71.5	66.3	20.9	250.7
Note: TBI incidencts occurring in some neighboring towns may have been counted in the city total. Caution should be used in interpreting these results.