Oct. 8, 2008 Traumatic brain injury is common amongst homeless people and is associated with poorer health, found a study of more than 900 homeless men and women in Toronto. Health problems include an increased risk of seizures, mental health problems, drug problems, and poorer physical and mental health status.
In this study of people in Toronto’s shelter system or who use meal programs, 58% of homeless men and 42% of homeless women had a history of traumatic brain injury. All participants had valid provincial health insurance. For many people, the first incidence of traumatic brain injury often occurred at a young age and “suggests that, in some cases, traumatic brain injury may be a causal factor that contributes to the onset of homelessness, possibly through cognitive or behavioural sequelae of traumatic brain injury,” state Dr. Stephen Hwang, a physician and research scientist at St. Michael's Hospital, and coauthors. Traumatic brain injury can result from falls, physical abuse, motor vehicle accidents and assaults.
These findings have implications in providing health care to homeless people, as some difficult behaviours in patients may be due to the results of brain injury. Appropriate supports may help mitigate the effects of these behaviours, suggest the authors.
There have only been 2 previous studies of this kind, both of which had small sample sizes.
Health care professionals need to ask homeless people if they have had traumatic brain injuries when providing health care. Neuropsychological screening, referral to rehabilitation programs and other community supports should be considered for the individual, write the authors.
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- Stephen W. Hwang, Angela Colantonio, Shirley Chiu, George Tolomiczenko, Alex Kiss, Laura Cowan, Donald A. Redelmeier, and Wendy Levinson. The effect of traumatic brain injury on the health of homeless people. CMAJ, 2008; 179: 779-784 DOI: 10.1503/cmaj.080341
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