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Rural Issues Associated with TBI

Rural Issues Associated with TBI

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Rural Issues Associated with TBI

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  1. Rural Issues Associated with TBI

  2. Levels of Blast Injury • Primary blast injury is related to the shock-wave overpressure and underpressure, • Secondary blast injury results from blast associated fragments or shrapnel • Tertiary blast injury occurs secondary to falling debris or throwing of the dismounted soldier or vehicle. • Quaternary blast injury develops from a variety of physical processes associated with explosive detonation such as thermal, toxic detonation products. • Quinaryeffects are sometimes included and refer to the environmental hazard remaining after an explosive detonation. Moore and Jaffee (2011)

  3. TBI • TBI is a commonly sustained blast injury that can pose a threat to veterans living in rural communities. • 44% (6.1 million) of men and women in the United States Armed Forces live in rural communities. • People with TBI living in rural areas were over two times more likely to be ill and dependent on others than those from urban areas.

  4. Medical and Other Service Issues • Multiple TBI is more prevalent in people living in rural communities. • Women with TBI from rural communities -financial hardship and difficulty accessing services, transportation, information and service coordination. • Limited access to medical services = many health complications that may result in long-term functional difficulty. • Outpatient TBI services are more readily available in urban areas.

  5. Vocational Issues • In DVR, maintenance services were provided to 46% of urban clients and 21.4% of rural clients • On the job training- 7.1% rural clients 28% urban • Transportation- 10.7% rural clients 36% urban • Services were more costly for consumers in urban areas. • 24% of urban clients were successfully placed and 7% of rural clients were vocationally successful.

  6. Vocational Issues Continued • Of rural clients, 79% qualified for services but were closed before services were offered or completed. This happened to 52% of clients from urban areas. • Multi-disciplinary services are lacking in rural areas due to shortage of qualified rehabilitation professionals.

  7. Medical Solutions • The Rural Veterans Access to Care Act of 2003 requires that 5% of funds appropriated to the VA for medical care must be provided to those veterans living in rural areas . • Office of Rural Health provides $250 million per year to ensure that vets have access to quality healthcare. • Training family as paraprofessionals

  8. Vocational Solutions • The Post 9/11 GI Bill has provided funds for the education of 215,000 veterans in rural areas. Of these, 3,600 live in extremely rural areas. • Wounded Warrior Tax Credit -proposed as an incentive for hiring veterans w/ service connected disabilities