Traumatic brain injury among American indians/alaska natives in the united states: a comprehensive systematic review of the literature.
Review
Overview
abstract
Traumatic brain injury (TBI) represents a significant public health burden, particularly among American Indian and Alaska Native (AI/AN) populations in the United States, and particularly in the State of Alaska. This systematic review aims to evaluate the incidence, risk factors, outcomes, and healthcare disparities associated with TBI in this population and to identify strategies for prevention and improved management. Following PRISMA guidelines, we conducted a systematic review of Medline/PubMed, Google Scholar, Web of Science, Scopus, and Embase through May 2025. Inclusion criteria targeted studies involving AI/AN populations in the United States that reported on epidemiology, causes of injury, hospitalization, and mortality rates, as well as healthcare access. Data were extracted and synthesized qualitatively as we summarized, compared, and interpreted findings narratively based on common patterns and themes. The NIH Quality Assessment Tool was used to evaluate the quality of the included studies. Fourteen studies met the inclusion criteria. AI/ANs exhibited significantly higher TBI-related emergency visits (1,026 per 100,000), hospitalizations (186.7 per 100,000), and mortality rates (up to 65.9 per 100,000) compared to other racial groups. Leading causes included motor vehicle accidents, falls, and self-harm. Geographic isolation, limited neurosurgical infrastructure, and mistrust towards non-Native healthcare providers exacerbated disparities. Interventions like telemedicine, community health training, and culturally sensitive healthcare were identified as potential solutions. AI/AN populations, particularly those residing in the state of Alaska, face significantly higher incidence and worse outcomes from TBI due to systemic healthcare barriers and regional challenges. These disparities necessitate a multifaceted, culturally informed approach that encompasses enhanced access to care, preventive strategies, and collaboration with tribal health organizations to mitigate the burden of TBI and improve long-term outcomes.
