As the global homeless population continues to climb, experts are working to find a link between the more than 100 million who live without homes. This week, a new study from the Lancet Public Health revealed one potential piece of the puzzle: that homeless people are disproportionately impacted by brain injury.
The systematic review, conducted by researchers from the University of British Columbia, analyzed 38 studies on homeless populations dating from 1995 to 2018. In the first meta-analysis of its kind, the researchers determined that 53 percent of homeless people have experienced a traumatic brain injury (TBI) and one in four have experienced one that is moderate or severe. Based on this data — in relation to the general population — homeless people are four times more likely to experience a TBI and ten times more likely to experience a moderate or severe one.
To grasp the significance of this data, it’s crucial to understand the different types of traumatic brain injuries.
According to the Mayo Clinic, a TBI is an injury that “results from a violent blow or jolt to the head or body.” A mild traumatic brain injury, like a concussion, is defined as one in which loss of consciousness occurs only briefly (under 30 minutes). Moderate and severe brain injuries, such as those suffered in a car accident, are characterized by a loss consciousness that lasts for several hours (or longer). In this case, the TBI can cause damage to the brain — such as bleeding and bruising — which can lead to life-threatening effects.
While the majority of TBIs are considered mild, the Centers for Disease Control and Prevention notes that the potential effects are wide-ranging. TBIs can impact memory, reasoning, sight, communication and understanding. Severe TBIs have also been linked to a variety of mental health issues, says the CDC, including “depression, anxiety, personality changes, aggression, acting out and social inappropriateness.”
One of the major differences that researchers found between TBIs in the general public and homeless populations was the cause. Among the general population, falling is the number one cause of TBI-related emergency room visits in the U.S. Motor vehicle crashes follow closely behind. But among the homeless population studied, violence was the leading cause. “We identified that the most common mechanism of injury was assault across all previous studies that have reported [the] mechanism of injury,” Jacob Stubbs, PhD student at the University of British Columbia, Canada, and member of the study tells Yahoo Lifestyle.
Stubbs says that one of the challenges of the study was determining whether the TBI preempted the individual’s living situation, or whether it may have been the result of inadequate shelter. “For many of the outcomes we looked at, like self-reported health, we were only able to identify an association between TBI and [homelessness],” he tells Yahoo Lifestyle. “However, for a few relationships, we were able to identify which came first. For example, we identified that TBI was a risk factor for subsequently becoming homeless. Notably, we also found that homelessness itself was a risk factor for sustaining TBI. This might indicate that TBI represents a barrier to exiting homelessness or an unstable housing situation.”
The authors of the study say that more research is needed to better understand why the prevalence of TBI is so high among homeless people. But in the meantime, Stubbs is hopeful it will inform the way homeless populations are treated.
“We hope that health care workers have an increased awareness for the burden of TBI in this vulnerable population,” he tells Yahoo Lifestyle. “Identifying TBI or problems stemming from brain injury may facilitate more targeted care and hopefully improved health for these individuals.”
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