The Hidden Dangers of TBI

Almost exactly one year ago, The Lancet, Public Health published an article entitled “Traumatic brain injury and homelessness: from prevalence to prevention,” looking at the growing public health concern of homelessness and its relationship to traumatic brain injury. With everything going on in the world during 2020, the Law Office of David Dwork felt some decidedly important connections between TBI and homelessness may be lost, and they really should not be.

In the article, they acknowledge that 50-60 million people will experience their first TBI, and roughly half the global population will experience at least one such injury in their lifetime. It also points out that TBI disproportionately affects young people and is the leading cause of death among children and adolescents in high-income countries. And, despite increased education and prevention efforts, TBI has increasing as a global problem.

The results of the study found that more than half of homeless and marginally housed individuals had a lifelong history of TBI, with almost a quarter of them having a history considered moderate or severe. Their evidence suggests that the risk factors for TBI closely align with the sort of overt causes of social exclusion, including poverty and marginalization. People who are homeless are more likely to die from injury than those of us in the general population.

They recognize that the identification of TBI among the homeless or marginally housed is challenging due to the high prevalence of severe mental illness, substance abuse, and “profound multimorbidity” within the group, making diagnosis problematic. However, they increased screening for TBI among homeless/marginally housed individuals in a clinical setting for more accurate diagnostic methods. They are keen to improve the efficiency and accuracy of TBI identification, primarily to help children and adolescents who may not be able to effectively communicate their symptoms. 

It is difficult to separate this report from similar studies finding TBI linked to increased suicidal ideation and risk of suicide. That report states that a common theme among the participants was the idea that there had been a “loss of self” and a “lack of purpose” since the injury that contributed to their thoughts of depression and suicide. One of the conclusions was that treatment geared toward helping patients to regain this sense of who they are is important.

That loss of self is a repeated notion when looking at homelessness correlated with TBI. In a news report issued by the Centers for Disease Control and Prevention (CDC) earlier this year, the CDC reported that suicide is the top cause of deaths tied to traumatic brain injury. The report says that nearly half of the 61,000 TBI-linked deaths recognized in 2017 were caused by suicide.

During the last 10 years of the study conducted, suicides surpassed unintentional motor vehicle crashes as the leading cause of TBI-related deaths. The shift was caused in part by a 32% increase in TBI-related suicide deaths among non-Hispanic whites. The leading categories of traumatic-injury related deaths included unintentional motor vehicle crashes, unintentional falls, and homicide.

The CDC findings concluded, “understanding the leading contributors to TBI-related death and identifying groups at increased risk is important in preventing this injury.” While *both* reports recommend that healthcare providers and public health officials increase their awareness of the burden of TBI in the population. 

While the transient nature of homelessness complicates the ability of clinical services to provide long-term follow up care and rehabilitation, the researchers acknowledge that TBI very often results in poor health, and the devastating functional and socioeconomic outcomes that can endure over a lifetime. 

The Law Office of David Dwork has over 30 years’ experience representing head injury victims and survivors and the families of those who require a traumatic brain injury lawyer. Knowing the underlying causes of TBI, as well as the possible long-term implications based on these sorts of scientific studies, is what makes this David Dwork the preferred personal injury lawyer from Quincy to Cambridge, Boston to Somerville. If you or your loved one has been the victim of a traumatic brain injury, you can contact us online or call 617-973-5024, to speak to David about your case today!