Abstract
BACKGROUND: Non-fatal traumatic brain injuries (TBIs) are commonly caused by falls, motor vehicle crashes and assaults, affecting millions of Americans each year. Yet there is limited information on the costs that non-fatal TBIs impose on affected individuals, families, employers and communities. This study used new data opportunities in a nationally representative survey to estimate annual productivity losses due to non-fatal TBI among US adults. METHODS: In 2025, authors combined survey response data from the 2023 National Health Interview Survey with supplementary information from previous studies and other nationwide data sources to estimate the cost of inability to work, absenteeism, presenteeism and household productivity loss from non-fatal TBI. Productivity losses were assessed using the human capital approach, which values lost time due to illness or injury using average observed wages in the population. RESULTS: Non-fatal TBI causes productivity losses among US adults each year exceeding an estimated US$19.1 billion (95% prediction intervals 7.5 to 35.6 billion) (2023 US$). The cost of inability to work comprises the greatest productivity losses (US$8.7 billion), followed by presenteeism (US$6.7 billion), absenteeism (US$3.5 billion) and household productivity loss (US$168 million). DISCUSSION AND CONCLUSIONS: The economic cost of lost productivity due to non-fatal TBI among adults is substantial. Public health strategies that prevent TBI have enormous potential to both alleviate suffering and create cost savings for the US economy by avoiding preventable work and personal time losses.