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Study examines links between homeless and vulnerably-housed individuals and traumatic brain injury

April 10, 2014

Traumatic brain injuries (TBIs) can result from vehicle accidents, firearms, falls and other causes. TBIs include things like concussions and are about seven times more common among homeless people than the general population.

A recent study of 968 participants conducted at St. Michael’s Hospital in Toronto is one of the first of its kind to look into the history of TBI among homeless and vulnerably-housed people and how TBI impacts on their lives.

The study found that individuals that are homeless or vulnerably housed and have a history of TBI were two times more likely to be arrested or incarcerated in the past year.

Dr. Stephen Hwang and his colleagues at the hospital’s Centre for Research on Inner City Health found that of those who participated in this study, 61 percent reported to have had a TBI in their lifetime. This ranged from 50 percent of those in Toronto, to 64 percent in Ottawa and 69 percent in Vancouver.

The study found that individuals that are homeless or vulnerably housed and have a history of TBI were:

  • 1.5 times more likely to visit the emergency department (ED) in the past year
  • 2 times more likely to be arrested or incarcerated in the past year
  • 3 times more likely to have experience a physical assault in the past year

Dr. Hwang believes that these findings could be reflective of the long-term cognitive effects of the initial TBI as well as the related health problems that may result, including substance use. He notes that these factors can lead to increased use of health services such as visits to the ED and contact with the law. This study uniquely found that sustaining a TBI is an independent risk factor for homeless and vulnerably-housed people to become victims of physical assault in the future.

Lead author and research student Michael To concludes that screening this vulnerable population for TBI and assisting them to manage behaviours after injury could improve health outcomes and lead to reduce costs in both the health and criminal justice systems.

To read the full study, visit the journal website.

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