April 26, 2021 - Podcast

Episode 121—Ticks, and traumatic brain injuries

Warmer weather brings more outside activity. And more outside activity increases one’s chance of encountering a tick. In Indiana, the presence of ticks appears to be growing—along with reports of tick-borne illnesses. At least 20 different disease-causing bacteria, viruses, and parasites are known to be transmitted from ticks to people. Depending on the disease, patients can experience symptoms that range from mild infections to chronic illness or death. Multiple factors are fueling tick population growth in the Midwest including warmer year-round temperatures, habitat fragmentation, and growing populations of preferred hosts, such as mice and deer. While ticks are commonly found in green spaces where people live, work, and play, IU experts say understanding the risks of tick exposure and implementing tick management practices around homes and neighborhoods can help minimize the health threat posed by ticks. There are multiple strategies that homeowners and green space managers can apply to reduce the risk of tick encounters. First, keep the grass cut short, one to three inches long, to ensure a tick-resistant environment that dries out quickly and does not retain moisture. Second, remove moisture-trapping leaf litter and trim shrubs to allow sunlight to penetrate through foliage and minimize dark, damp spaces around plants. Third, create a 3-foot barrier of gravel or mulch between tick habitat and lawn to keep ticks at bay and remind people not to enter tick habitat. Finally, discourage the presence of animals who host ticks by installing a deer fence, eliminating seed waste from bird feeders, and removing rodent-friendly invasive species, such as Japanese barberry, Eurasian honeysuckle, and multiflora rose.

In other news, patients who suffer from traumatic brain injuries, or TBI, often need a great deal of health care services after the injury, but the extent of their care utilization is unknown. A new study from research scientists at IUPUI, the U.S. Department of Veterans Affairs, and Regenstrief Institute is one of the first to analyze how much care traumatic brain injury patients use and identify areas of unmet need. The research team looked at patients who were hospitalized with a TBI from 2005 through 2014 and examined health care utilization data for one year after the TBI event. That data was broken down into three categories: emergency department, inpatient, and outpatient care. Researchers found that many TBI survivors needed extensive health care services in the year after their injury, and a quarter of them were super-utilizers, having three or more emergency department visits or inpatient encounters or more than 26 outpatient visits during the year. The results indicate that health insurance impacted the amount and type of care utilized, as did race, gender, and residency status. Study authors say these potential disparities are an important area to focus on in future research. A previous study by Johanne Eliacin, a Regenstrief Institute research scientist, identified some of the challenges patients and caregivers report, such as the struggle to understand what care is available and where to access it. But Eliacin says more work is needed to dig into the social determinants of health that impact a TBI survivor’s outcome and to understand the struggles faced by those who are high utilizers of the health care system.