Traumatic brain injury (TBI) can have lasting physical, cognitive, and emotional health effects that extend well beyond the initial event. In March 2025, the National Academies' Forum on Traumatic Brain Injury convened a workshop to explore TBI as a chronic condition and to identify opportunities to improve lifelong care.

Participants examined evidence supporting the classification of TBI as a chronic condition, explored the biological mechanisms that drive long-term outcomes, and discussed the complex comorbidities that can persist or emerge years after injury. Lived experience perspectives shared throughout the workshop underscored the human impact of these issues and the importance of sustained, multidisciplinary support for recovery and well-being. This Proceedings of a Workshop summarizes presentations and discussions from the workshop.

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Building a strong state infrastructure takes time, effort, and planning from many individuals and organizations. There are several key components necessary to create a comprehensive state system of services, partners, funding, and policy. Infrastructure building is a process and requires routine assessment, regardless of the level achieved. This tool, Strong Infrastructure Components for Brain Injury (BI): State Self-Assessment Tool, produced by ACL's Traumatic Brain Injury (TBI) Technical Assistance and Resource Center (TARC) was created to assist BI partners and collaborators in determining which level best describes their state’s progress, and to give some guidance to what a more comprehensive system could include. It is designed to be a guide, and states should consider re-assessing routinely, or at various points to assist in state planning efforts, such as conducting a new needs assessment, developing, or updating a state plan, or applying for a grant opportunity.

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This map shows state-level rates of traumatic brain injury (TBI)-related deaths in 2023. NASHIA members can use these data to raise awareness of the burden of TBI in their state, inform prevention and service planning, strengthen funding proposals, and compare outcomes across states. Understanding where TBI deaths are highest helps guide strategies to improve brain injury prevention, care, and supports for survivors and families.

Also included are ways for NASHIA members and the brain injury community to action these data.

NASHIA would like to thank Dr. Dana Waltzman from Indiana University School of Medicine for working with us on this infographic.

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