Traumatic brain injuries, such as concussions, are about seven times more common among homeless people than the general population, according to researchers. The homeless also are known to be frequent users of hospital emergency departments for health care.
“Given the high costs of emergency department visits and the burden of crime on society, these findings have important public health and criminal justice implications,” researchers from St. Michael’s Hospital in Toronto wrote in the study, which was published in the Journal of Head Trauma Rehabilitation.
The latest findings come from an ongoing study of changes in the health and housing status of 1,200 homeless and “vulnerably housed” single adults in Vancouver, Toronto, and Ottawa. The Health and Housing in Transition study has been following participants for up to four years.
Of those being followed by the study, 61 percent said they had suffered a TBI some time in their lifetime, according to researchers. The breakdown shows that number increases to 69 percent in Vancouver, and 64 percent in Ottawa, while it was 50 percent in Toronto.
The study found that homeless people with a history of TBI were about 1.5 times more likely to have visited an emergency department in the previous year, possibly due to long-term cognitive effects of the original TBI. Previous research has shown that people with TBI are high users of health care services up to five years after the original injury.
According to Dr. Stephen Hwang of the hospital’s Centre for Research on Inner City Health, frequent emergency department visits could also be related to health problems related to the TBI, such as seizures or substance use.
The study also found that the homeless with TBI were almost twice as likely to have been arrested or incarcerated in the previous year.
Hwang speculated that this could be due to impaired cognition or personality disturbances following TBI.
The study also found that they were almost three times more likely to have experienced a physical assault in the previous year.
This is consistent with previous studies that suggested people with a history of TBI are more likely to be victims of violent crime, according to the researchers.
Hwang noted that this is one of the first studies to suggest that sustaining a TBI is an independent risk factor for becoming a future victim of physical assault.
“Screening homeless and vulnerably housed people for TBI and helping them to better manage behaviors after brain injuries could help improve outcomes and potentially reduce the use of costly health care and legal services,” concluded Matthew To, lead author of the study and a research student at St. Michael’s Hospital.
Source: St. Michael’s Hospital