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Brain injury most prevalent among homeless

Brain injury most prevalent among homeless

precariously housed populations. As a result, health care professionals and service providers need standardized training to screen for symptoms of even mild injury involving people often struggling with challenges like mental illness and cognitive impairment.

“This is especially troubling for Hamilton considering the homeless and precariously housed within our community are facing so many hurdles as it is. “

The study, published this week in the journal EClinicalMedicine-Lancet, included 326 participants recruited from Vancouver’s low-income Downtown Eastside, a community court and the emergency department of a nearby hospital. Nearly 10 per cent of brain injuries occurred in the context of a drug overdose, while more than 60 per cent were related to substance use.

 Homeless and precarious housed persons are particularly prone to traumatic brain injuries (TBIs), but tracking incidence rates are hampered by poor case acquisition. However the researchers were able to document TBIs in precariously housed persons transitioning in and out of homelessness.

Between December 2016 and May 2018, 326 precariously housed participants enrolled in a longitudinal study in Vancouver were assessed monthly for TBI occurrences. Over one year, 2433 TBI screenings were acquired for 326 person-years were evaluated.

Findings

One hundred participants acquired 175 TBIs, yielding an observed incidence proportion of 30·7% and event proportion of 53·7%. Of the injured, 61% reported one TBI and 39% reported multiple injuries. Acute intoxication was present for more than half of the TBI events assessed. Additionally, 9·7% of TBI events occurred in the context of a drug overdose. Common injury mechanisms were falls (45·1%), assaults (25·1%), and hitting one’s head on an object (13·1%).

The researchers commented that given the prevalence of TBIs revealed in this precariously housed sample, “ we identify an underappreciated and urgent healthcare priority.”

“As much of the research and clinical attention has focused on affluent populations, including sport-related concussions in athletes, the attention on brain injury in homeless and precariously housed persons is lacking,” says Dr. Tiffany O’Connor, lead author of the study and Clinical Neuropsychologist in the Acquired Brain Injury Program at Hamilton Health Sciences (HHS). “This is of serious concern considering this population has numerous risk factors for experiencing brain injury, and may face worse consequences from these injuries. We are seeing a vicious cycle where intervening is imperative.”

“This is especially troubling for Hamilton considering the homeless and precariously housed within our community are facing so many hurdles as it is. “

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