Are Brain Injuries to Blame for Homelessness?

Homelessness is becoming epidemic in size with an estimated 150,000 to 300,000 people being classified as “visibly homeless” in Canada. In the United States, estimates show around 670,000 people are homeless a night. While poverty is one of the main reasons for homelessness, there are many more complex reasons why people might become homeless. Now recent research in Canadian Medical Association journal suggests that homeless men are more likely to have a history of brain injury.

The study recruited 111 men from an urban men’s shelter in Toronto and saw that 45% of the participants had positive test results for a traumatic brain injury. Traumatic brain injury is defined as disruption in normal brain function caused by a bump or blow to the head. A common type of traumatic brain injury is a concussion. Not all blows to the head will cause a traumatic brain injury and the severity of injury can range from mild to severe. In the study, 73% of the men experienced their brain injury before the age of 18 and 87% of them experienced the injury before they became homeless. What are the causes of these traumatic brain injuries in these men? The majority (66%) reported the brain injury was from assault at some point in their life. Other causes of injury were sports (42%), motor vehicle accident (42%) and falls (42%). It was also noted that brain injury was significantly associated with substance abuse and mental illness.

So, what does it all mean? Is brain injury a risk factor for homelessness? Possibly. However not everyone who gets a concussion ends up homeless. Poverty still remains one the greatest risk factors for homelessness. It is possible that having a traumatic brain injury (and/or mental illness) makes it more difficult for you to get yourself out of poverty or prevent yourself from getting into poverty. Similarly it is possible that having a series of brain injuries might lead to mental illness or substance abuse, which in turn might lead to poverty or homelessness.

A few things should be noted about this study. First, this study was limited to only one shelter in Toronto and therefore it may not be generalizable to the larger homeless picture. More studies should be done looking at larger populations across North America. Secondly, most of the data was collected through self-reporting and therefore depends on the ability of the subjects to recall facts. Seeing as a side effect of brain injuries is difficulty with memory, there might be under or over reporting of abuse or injury that could affect the results. There needs to be more work done to try to determine the link between brain injury and homelessness or poverty. As it stands, this research likely points to a lifetime of abuse or injury that causes brain injury and may lead to mental illness or substance abuse, both of which are strongly associated with homelessness. In closing, this study adds one more concern to a growing list of problems associated with concussions and traumatic brain injuries. More research into preventing concussions in sports, especially in youth sports, should be done. Also, since many of the men in the study had experienced abuse at some point in their life, finding ways to eliminate abuse might be an effective way of treating traumatic brain injury and indirectly, homelessness.

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