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Research into head injuries

June 15 2012
Brain injury could contribute to the risk of becoming homeless, according to a groundbreaking study


Homeless people are more likely to be affected by brain injury, and it could contribute to the risk of becoming homeless, according to a groundbreaking study launched last week by The Disabilities Trust Foundation.

The study found that homeless people were more than twice as likely to have experienced a traumatic brain injury (TBI) than people who were not homeless, and the majority of these reported that they had sustained their first injury before becoming homeless.

The research, which took place in Leeds, was led by Professor Michael Oddy and involved 100 homeless participants, including 75 men and 25 women. There was also a control group of 100 people who were not homeless. The participants were asked a number of questions in face-to-face interviews, including whether they had sustained a TBI, at what age, and whether they were homeless at the time.

Of the homeless participants, almost half (48 per cent) reported that they had suffered a TBI, against just 21 per cent in the control group. Of the homeless participants who had suffered a TBI, the vast majority (90 per cent) said that their first injury had been prior to them becoming homeless, which indicates that sustaining a TBI could increase the risk of a person becoming homeless.

Among other findings, 60 per cent of homeless participants with a history of TBI said they had sustained more than one, compared to 24 per cent in the control group. The median age at which the first injury was suffered was 19.9 years, which indicates that many participants experience their first TBI at a young age. Brain injury can cause cognitive dysfunction, which affects individuals differently but may affect a person’s memory, communication and behaviour. Previous academic studies have suggested that there is a higher incidence of cognitive dysfunction among homeless people than the general population, and brain injury has been identified as one possible contributing cause of this.

The first, and until now only, study into the relationship between TBI and homelessness was carried out in 2008 in Toronto, Canada, and led by Dr Stephen Hwang. When the researchers asked 900 homeless men and women if they had sustained a TBI, 53 per cent said that they had, and that 70 per cent of these sustained their first injury before becoming homeless.

This research suggested that rates of TBI among homeless people were significantly higher than in the general population (found to be 8.5 per cent in the US in 2001). However, the study did not include a matched control group, a limitation that is addressed in The Disabilities Trust’s study. Following the preliminary study in Leeds, further research is planned to take place in Glasgow that will examine medical records and compare these with records of homelessness. It is intended that eventually the research will be able to help health, housing and care professionals to adapt their practice to take into account the possibility that homeless people may have a TBI.

Chief executive of The Disabilities Trust, Barrie Oldham, said: “An estimated 100,000 people in the UK live with long-term disabilities as the result of brain injury - a ‘silent epidemic’. We know that these injuries can shatter people’s lives and this groundbreaking research is the first step towards a better understanding of the possible link between homelessness and brain injury. There is much more work to be done to develop the evidence base and we are already starting work on a further study to compare homelessness information with medical records.”

The study was launched during Brain Injury Awareness Week, which took place on 14-20 May 2012. The aim of the week is to raise awareness of how people, particularly children, can protect themselves from brain injuries, and how people who have sustained a brain injury can be supported. The Brain Injuries Rehabilitation Trust, a division of The Disabilities Trust, marks the week with a series of events across the UK.