Close to half of all homeless men who took part in a study by St. Michael’s Hospital had suffered at least one traumatic brain injury in their life and 87 percent of those injuries occurred before the men first became homeless.
Although assaults were among the leading causes of those traumatic brain injuries (TBIs), (60%) many were caused by potentially non-violent means such as sports and recreation accidents (44%) and automobile collisions and falls (42%).
The study, led by Dr. Jane Topolovec-Vranic, a clinical researcher in the hospital’s Neuroscience Research Program, was published in the journal CMAJ Open. Dr. Topolovec-Vranic said it’s important for health care providers and others who work with homeless people to be aware of any history of head injuries because of the direct links between such injuries and mental health issues, substance abuse, seizures and general poorer overall physical health.
The fact that so many homeless men experienced a traumatic brain injury before losing their home suggests such injuries are a likely risk factor for becoming homeless, according to her. That makes it even more important to monitor young people who suffer head injuries such as concussions for health and behavioral changes, she added.
Dr. Topolovec-Vranic focused on a group of 111 homeless men ages 27-81 who were recruited from a men’s shelter in downtown Toronto. She found that 45% of these men had experienced a traumatic brain injury, and of these, 70% were injured during their childhood or teenage years while 87% experienced an injury before they lost their home. In men under age 40, falls from drug/alcohol blackouts were the most common cause of head injury while assault was the most common in men over age 40.
Recognizing that a brain injury sustained in childhood or early teenage years could predispose someone to homelessness may challenge some assumptions that homelessness is a conscious choice made by an individual or just the result of their addictions or mental illness, noted Dr. Topolovec-Vranic. This study received funding from the Canadian Institutes of Health Research and the Ontario Neurotrauma Foundation.
Separately, a recent but related study by Dr. Stephen Hwang of the hospital’s Centre for Research on Inner City Health, found the number of people who are homeless or vulnerably housed and who have also suffered a traumatic brain injury may be as high as 61% — seven times higher than that of the general population.
Dr. Hwang’s study, published in the Journal of Head Trauma Rehabilitation, is one of the largest studies to date investigating a history of head injury in homeless populations. The findings come from the Health and Housing in Transition Study, which tracks the health and housing status of homeless and vulnerably housed people in Toronto, Vancouver and Ottawa.
Traumatic Brain Injury (TBI) Statistics
- On average, one person in the US sustains a TBI every 21 seconds
- Of those who experience a civilian traumatic brain injury (TBI) each year:
o 50,000 die
o 235,000 are hospitalized
o 1.1 million are treated and released
- 1/3 of all accident-related deaths are associated with TBI
- An average of nearly 470,000 annual emergency department visits consist of children ages 0-14 years
- Senior citizens ages 75 and older have the highest rates of TBI-related hospitalization and death over any other age group.
- Men who are heavy drinkers and/or have been homeless for a long period of time tend to have 400 times the number of head injuries when compared with the general population
- The total lifetime costs of treating a person with a TBI are estimated to be between $600,000 to $1.8 million
References:
High Hopes for TBI
