Traumatic Brain Injury may be Linked to Homelessness

Researchers are trying to find out more about the traumatic brain injuries of homeless people. According to a recent study, homeless people have a disproportionately higher risk for a traumatic brain injury (TBI) compared to the general population. However, very little is known about the severity of their injuries and who exactly is suffering from them and what the long-term consequences are.

"A better understanding of TBI, its presentation and characteristics in the homeless is vital in order to enable appropriate interventions, treatments, and case management in the improvement of outcomes for this important segment of the population," said Dr. Jane Topolovec-Vranic, a clinical researcher in the Trauma and Neurosurgery Program at St. Michael's Hospital.

"Reducing the prevalence of homelessness and the incidence of injury and illness among people who are homeless would have significant financial, societal and individual implications."

Traumatic brain injuries are caused by a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. The severity can range from mild, characterized by a brief change in mental status, to severe, which could include unconsciousness or amnesia. TBI is associated with low subsequent employment rates, which can contribute to a downward spiral into homelessness.

Yet he acknowledges that while this new research indicates that there are high amounts of TBI among the homeless, there is little data to show this.

The findings of Dr. Topolovec-Vranic and his team show that as many as one in nine Canadians have experienced homelessness or come close to it. Previous research also has found that homeless people often suffer from serious health conditions, use the most expensive medical interventions such as emergency rooms, require longer hospital stays than people with homes and are at increased risk of death.

They, too, found that anywhere between 8 and 53 percent of homeless people-mostly men--have traumatic brain injuries, and the majority who have suffered a TBI before becoming homeless, suggesting TBI might be a risk factor for homelessness. It's also possible that impulse control disorders, for example, could predispose individuals to both TBI and homelessness.

Their findings were published recently in the journal BMC Public Health.