Tech + Health

04.28.14

New Research Shows Half of All Homeless Have Suffered Traumatic Brain Injury

Half of America’s homeless have suffered a brain injury—87 percent of those before they lost their homes. How a new study could give new insight into what causes homelessness.

Rates of traumatic brain injuries (TBI) have spiked sharply over the past few years, with the combined number of people visiting the emergency room, being hospitalized, and dying as a result of their impairment at its highest for a decade. A recent study found that nearly half of all homeless people have suffered from a TBI, 87% of which occurred before they lost their homes.

Considering that there are over 600,000 people sleeping on America’s streets on any given night, this is no minor issue. The research, led by Dr. Jane Topolovec-Vranic of St. Michael’s Hospital, showed that most TBIs were caused by assault (60%), sports and recreation (44%), or motor collisions/falls (42%), and that nearly three-quarters of these injuries happened before people reached the age of 18.

The findings are important in demonstrating that homelessness can often be created by medical—as opposed to lifestyle—deviations. “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,” Dr. Topolovec-Vranic explains.

The fact that a solid portion of those studied were injured doing everyday things like riding in their car or playing a sport, and then ended up on the streets, is something that cannot be ignored. For those that initially got hurt due to, say, gang-related violence in their teens, it’s perhaps more understandable that they’d have a predilection for making less than sensible decision—ones that could eventually see them without a home. But what about those whose traumas were the result of a freak accident? What about people who, as a result of a TBI, had their personalities altered completely?

“You could see how it would happen,” Dr. Topolovec-Vranic continues. “You have a concussion, and you can’t concentrate or focus. Their thinking abilities and personalities change. They can’t manage at work, and they may lose their job, and eventually lose their families. And then it’s a negative spiral.” While establishing a link between TBIs and homelessness can only be conjecture at this point, the statistics appear to illustrate just how life-changing such a trauma could be, how plausible the connection appears. Participants in the study were also “significantly more likely to have been arrested [and] to have a lifetime history of mental illness,” again reinforcing the enduring detriment caused by suffering a TBI.

The fact that a solid portion of those studied were injured doing everyday things like riding in their car or playing a sport, and then ended up on the streets, is something that cannot be ignored.

These stats raise a number of important questions, namely: Can those who have had accidents of this ilk really be receiving proper rehabilitation if nearly half of them end up living on the street? It seems to be too high a proportion to attribute to coincidence, and if proof of this causation is established, the process of dealing with TBI victims will need to be made a hell of a lot more robust. Biologist Victoria Wood agrees: “Effective monitoring and providing support to these vulnerable people is clearly essential. That some who screened positive for TBIs had been shown to have a history of mental illness further highlights the need for more research into the biological effects of these kinds of injuries to see if the outcomes can be preventable in the future.”

A separate study recently found that the number of homeless or vulnerably housed people that had suffered a TBI was 61%—almost seven times the population’s average. Another discovered that nearly half of New York City’s young offenders’ institutions’ newly admitted adolescents had been on the receiving end of a brain trauma. All this continues to point toward the notion that there is insufficient rehabilitative care in place for those who need it. The fact that such a large number of these injuries occur during adolescence is concerning—there can be no good reason why children are left to cope with serious medical issues unsupported, particularly when the consequences can be as grave as losing one’s home. This can’t just be a matter of discharging kids from hospitals because they seem fine and never checking up on them again—there needs to be consistent, long-term assistance for these people, whether they realize they need it or not.

Because better monitoring TBI sufferers could not only help them to re-adjust to their lives after injury, it could in turn massively impact overall levels of homelessness in the U.S., and these are outcomes that yield too much promise to be ignored.

If there’s a way of protecting the people in society who need it most, and reducing the number of people forced to live on the street, we should be doing everything we can to put these changes in place.