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Episode 53: TBI In The Homeless Population

During brain injury awareness month, I would be remiss if I did not discuss the frightening and often overlooked incidence of traumatic brain injury in the homeless population.

With homelessness increasing in the United State due to among other causes, poverty, unmet psychiatric needs, and housing shortages, it’s time we devote more attention and resources to this problem. 

And let’s not overlook, studies which have documented veterans are 50% more likely to become homeless than other Americans

With this in mind, let’s review shocking studies linking homelessness and traumatic brain injury.

In a 2019 comprehensive study reported in the prestigious Lancet Public Health Journal,  researchers found the lifetime prevalence of any severity of traumatic brain injury in homeless and marginally housed individuals was 53.1 percent, and the lifetime prevalence of either moderate or severe TBI was 22.5 percent.   

A further study published in Lancet earlier this year found similar incidences of TBI among the homeless and marginally homeless and reported common injury mechanisms were falls, assaults, and being struck on the head. Intoxication and drug overdoses were contributing factors to the event in more than ½ of the cases.

In an editorial accompanying the original Lancet article, the editors state, “It is becoming increasingly clear that TBI can be both a cause and consequence of homelessness.”

TBI can put a person at increased risk for neurologic and psychiatric conditions, which could become part of a cascade of factors that lead to homelessness. Living on the street or in a shelter puts a person at risk for falls, assault, and other violent acts leading to a traumatic brain injury.

Any social or medical evaluation of homeless individuals should include a comprehensive evaluation for traumatic brain injury with referral for care and rehabilitation.

So, during brain injury awareness month, discussion of the silent epidemic of traumatic brain injury must include our nation’s homeless population.

Audio version

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