High incidence of TBIs in study of houseless and precariously housed persons
By Aamy Woldesenbet. This article was initially published in our Concussion Update newsletter; please consider subscribing.
A recent study by Tiffany O’Connor et al., published in the Lancet journal eClinicalMedicine, explored the incidence of traumatic brain injury among homeless and precariously housed persons. A previous study established that these individuals experience a disproportionately high lifetime prevalence of TBI in comparison to the general population. This cohort study enrolled 326 precariously housed individuals in Vancouver, Canada, between December 2016 and May 2018. Each of the participants was monitored on a monthly basis to check for occurrences of TBI.
Of the 326 individuals who participated in the study, 100 acquired at least one TBI during the study period (with 31% suffering more than one) – yielding an incidence proportion of 30.7%. The event proportion, the number of occurrences throughout the study population, was 53.7%. Acute intoxication was present for the majority of the TBI events, and approximately 10 percent of the incidents occurred during a drug overdose. The three most common injury mechanisms were falls, assaults, and hitting one’s head on an object.
In an article on CBC news, the researchers suggest that concussions, as opposed to moderate or severe TBIs, may not get reported, which leads them to believe that “TBIs among Downtown Eastside residents might even be higher.”
The study authors also found that “exploratory analyses identified factors associated with odds of an incident TBI over one year of follow-up, including: schizophrenia disorders, opioid dependence and those reporting past TBIs.” Considering how prevalent TBI’s are in the homeless and precariously housed populations, the authors argue that the issue should be given higher priority in healthcare. Effect modifiers of TBI incidence present in the study can help guide investigations into prevention efforts to lower the currently high rate of injury.
