Homeless people frequently affected by Traumatic Brain Injury

An extensive meta-analysis found that over half of all homeless people in high-income countries suffer from Traumatic Brain Injury. A particularly serious problem was also revealed: These traumatic injuries range from moderate to severe in 25 percent of those assessed.

TBI identified in 53 percent of all homeless people in six high-income countries

According to an extensive meta-analysis, over half of all homeless people in high-income countries suffer from  Traumatic Brain Injury (TBI). The current research results reveal a particularly serious problem: These traumatic injuries even range from moderate to severe in 25 percent of the homeless people assessed.

As part of their study, the researchers looked at 38 studies published between 1995 and 2018 that tackled the frequency of Traumatic Brain Injury (TBI) among people in homelessness or uncertain housing environments. After comparing the research with the general population, those with home insecurity had a four-fold higher risk of TBI. The risk of moderate to severe TBI was even ten times higher than in the general population.

Based on the data available to them, the research team was unable to determine whether craniocerebral trauma increased the risk of homelessness or whether homelessness more often led to craniocerebral trauma. From the researchers' point of view, however, it was clear that in either case, a stable home environment could significantly reduce the risk of TBI.

A risk factor, that is often underestimated

"Craniocerebral trauma is a significant, all too often underestimated risk factor in assessing the health and functionality of this particularly vulnerable population group," said Dr. William Panenka, a study co-author.

Leading author, Jacob Stubbs, added: "I am particularly concerned about the much higher risk of moderate to severe craniocerebral trauma. Our work highlights the need for healthcare workers to be aware of the increased burden of TBI in this population group and consider how it affects health".

TBI has implications and consequences for many life factors

The 38 research papers considered for the current study included data from Australia, Canada, Japan, South Korea, Great Britain, and the USA. They included people of all ages who were either homeless, living in uncertain housing situations, or using homeless services.

The team evaluated the number of new and existing cases of TBI and the relationship between craniocerebral trauma and general health. The researchers concluded that in all cases, TBI was associated with poorer physical and mental health, increased risk of suicide, memory loss, increased need for health services and increased contact with the criminal justice system.

Jacob L Stubbs, Allen E Thornton, Jessica M Sevick, Noah D Silverberg, Alasdair M Barr, William G Honer, William J Panenka. Traumatic brain injury in homeless and marginally housed individuals: a systematic review and meta-analysis. The Lancet Public Health, 2019; DOI: 10.1016/S2468-2667(19)30188-4