A recent study of homeless men in Toronto shows that almost half had suffered at least one traumatic brain injury in their life and the majority of those injuries occurred before the men lost their homes.
While assaults were a major cause of those traumatic brain injuries, or TBIs, 60 percent were caused by potentially non-violent mechanisms such as sports and recreation (44 percent) and motor vehicle collisions and falls (42 percent). The study, led by Jane Topolovec-Vranic, an assistant professor at the University of Toronto, was published in the journal CMAJ Open.
Topolovec-Vranic says it’s important for health care providers and others who work with homeless people to be aware of any history of TBI because of the links between such injuries and mental health issues, substance abuse, seizures, and general poorer physical health.
The fact that so many homeless men suffered a TBI before losing their home suggests such injuries could be a risk factor for becoming homeless, she says. That makes it even more important to monitor young people who suffer TBIs such as concussions for health and behavioral changes, she says.
Topolovec-Vranic looked at data on 111 homeless men aged 27 to 81 years old who were recruited from a downtown Toronto men’s shelter. She found that 45 percent of these men had experienced a traumatic brain injury. Of these, 70 percent were injured during childhood or teenage years and 87 percent experienced an injury before becoming homeless.
In men under age 40, falls from drug/alcohol blackouts were the most common cause of traumatic brain injury, while assault was the most common in men over 40 years old.
Recognition that a TBI sustained in childhood or early teenage years could predispose someone to homelessness may challenge some assumptions that homelessness is a conscious choice made by these individuals, or just the result of their addictions or mental illness, says Topolovec-Vranic.
Separately, a recent study by Stephen Hwang of the hospital’s Centre for Research on Inner City Health and an associate professor in the Dalla Lana School of Public Health at the University of Toronto found the number of people who are homeless or vulnerably housed and who have also suffered a TBI may be as high as 61 percent, seven times higher than the general population.
Hwang’s study, published in the Journal of Head Trauma Rehabilitation, is one of the largest studies to date investigating TBI 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.
The Canadian Institutes of Health Research and the Ontario Neurotrauma Foundation provided funding for Topolovec-Vranic’s study.