UT San Antonio scientist helps shape new traumatic brain injury guidelines – UT Health San Antonio

Report on New National Guidelines for Traumatic Brain Injury (TBI) Care and Alignment with Sustainable Development Goals (SDGs)

Introduction: A Strategic Response to a Global Health Issue

Traumatic Brain Injury (TBI) represents a significant public health challenge, affecting millions of individuals annually and often leading to long-term health complications. In a major advancement for patient care, new national recommendations have been established to provide more effective short- and long-term care. These guidelines, developed by a National Academies of Sciences, Engineering and Medicine working group, represent the most comprehensive update in over a decade and are fundamentally aligned with several key United Nations Sustainable Development Goals (SDGs).

Advancing SDG 3: Good Health and Well-being

The primary objective of the new guidelines is to ensure healthy lives and promote well-being for all, directly contributing to SDG 3. The recommendations establish a new standard of care that moves beyond acute treatment to address long-term health outcomes.

• Comprehensive Long-Term Care: The guidelines emphasize patient follow-up care beyond the initial injury phase, recognizing that even TBIs not requiring hospitalization can lead to chronic symptoms and disability.
• Holistic Health Monitoring: A call for structured follow-up and attention to cognitive, mood, and functional changes ensures a more holistic approach to patient well-being.
• Early Rehabilitation: By recommending early referral to rehabilitation services, the guidelines aim to maximize recovery and improve the quality of life for individuals living with TBI.

Promoting SDG 10: Reduced Inequalities

A core principle of the updated guidelines is the promotion of equitable healthcare, a central tenet of SDG 10. The framework aims to close significant gaps in care and address the needs of diverse and vulnerable populations.

• Standardizing Care: The guidelines address the critical issue that less than half of TBI patients currently receive any form of follow-up, seeking to create a consistent and equitable standard for all.
• Inclusive Application: The recommendations are designed for individuals with any level of TBI severity, whether or not hospitalization was required, ensuring broader access to quality care.
• Focus on Vulnerable Groups: Specific considerations are included for populations that may face unique challenges or higher risks, including:
1. Older adults
2. Athletes
3. Military service members
4. Survivors of intimate partner violence

Integrating Social Determinants of Health: A Link to SDG 1, SDG 2, and SDG 5

A pivotal update in the guidelines is the mandate for health professionals to screen all TBI patients for health-related social needs. This approach acknowledges that health outcomes are inextricably linked to social and economic conditions, directly supporting goals related to poverty, hunger, and gender equality.

• Addressing Systemic Barriers: Screening for insecurities related to food (SDG 2), housing (SDG 1), transportation, and finances (SDG 1) identifies critical barriers that can prevent patients from accessing follow-up visits, medication, and rehabilitation.
• Supporting Gender Equality (SDG 5): By explicitly including considerations for survivors of intimate partner violence, the guidelines recognize a key cause of TBI among women and promote targeted, sensitive care for this vulnerable group.

Conclusion: A Framework for Sustainable and Equitable Health Outcomes

The new national guidelines for TBI care offer a practical, evidence-informed framework that empowers primary and specialty care providers to deliver more consistent and effective treatment. By integrating a focus on long-term well-being, equity, and the social determinants of health, this initiative marks a significant step toward achieving the Sustainable Development Goals and improving outcomes for millions of individuals living with the effects of traumatic brain injury.

Analysis of Sustainable Development Goals (SDGs) in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

1. SDG 3: Good Health and Well-being
   • The entire article focuses on improving health outcomes for individuals with Traumatic Brain Injury (TBI). It discusses new national guidelines for more effective short- and long-term care, rehabilitation, and management of long-term symptoms, which directly aligns with the goal of ensuring healthy lives and promoting well-being.
2. SDG 10: Reduced Inequalities
   • The article emphasizes making TBI care more “equitable.” It addresses the gap where “less than half of patients receive any form of follow-up” and calls for specific considerations for vulnerable groups like “older adults, athletes, military service members and survivors of intimate partner violence,” aiming to reduce health disparities.
3. SDG 1: No Poverty
   • The new guidelines explicitly call for screening patients for “financial insecurity.” The article notes that this factor can “directly impact whether patients are able to attend follow-up visits, access medications or continue rehabilitation,” linking the fight against poverty to the ability to achieve good health.
4. SDG 16: Peace, Justice and Strong Institutions
   • The development of “new national recommendations” and “updated clinical practice guidelines” to “establish standards that hospitals, rehabilitation centers and outpatient clinics can apply” represents an effort to build more effective and accountable healthcare institutions. This institutional strengthening aims to provide consistent and evidence-informed care.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • The guidelines’ focus on long-term care and “attention to cognitive, mood and functional changes” that develop after TBI directly contributes to promoting mental health and well-being for individuals living with the long-term consequences of injury.
2. Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services…
   • The article addresses the need to close gaps in follow-up care and ensure access to rehabilitation. By calling for screening for social needs like “food, housing, transportation and financial insecurity,” the guidelines aim to remove barriers and ensure all TBI patients can access quality care.
3. Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
   • The guidelines promote the inclusion of persons with disabilities (TBI) and other vulnerable groups by recommending tailored care and addressing social barriers, ensuring they are not left behind in the healthcare system.
4. Target 10.3: Ensure equal opportunity and reduce inequalities of outcome…
   • By creating standardized, “equitable” care guidelines, the initiative aims to reduce the “wide variability and gaps in follow-up care,” thereby reducing inequalities in health outcomes for TBI patients regardless of their background or where they receive care.
5. Target 1.3: Implement nationally appropriate social protection systems and measures for all…
   • The recommendation to “screen all TBI patients for health-related social needs such as food, housing, transportation and financial insecurity” is a measure to identify vulnerable individuals who may need social protection to achieve positive health outcomes.
6. Target 16.6: Develop effective, accountable and transparent institutions at all levels.
   • The creation and dissemination of evidence-informed “clinical practice guidelines” for hospitals and clinics is a direct action to make these healthcare institutions more effective and accountable in delivering standardized, high-quality TBI care.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Percentage of TBI patients receiving follow-up care
   • The article provides a baseline by stating, “Less than half of patients receive any form of follow-up.” An increase in this percentage would be a direct indicator of progress in closing the care gap and moving towards Target 3.8.
2. Rate of screening for health-related social needs
   • The guidelines call for screening “all TBI patients for health-related social needs.” Measuring the percentage of patients who are screened for food, housing, transportation, and financial insecurity would indicate the implementation of policies aimed at achieving Targets 1.3 and 10.3.
3. Rate of adoption of the new clinical practice guidelines
   • Progress towards Target 16.6 can be measured by tracking the number or percentage of “hospitals, rehabilitation centers and outpatient clinics” that formally adopt and apply the new national guidelines for TBI care.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article. In this table, list the Sustainable Development Goals (SDGs), their corresponding targets, and the specific indicators identified in the article.

Source: news.uthscsa.edu