ABSTRACT
OBJECTIVE: To characterize the traumatic brain injury profile and its associated risk factors in homeless individuals in Santa Clara County, CA. DESIGN: Observational cohort study SETTING: : Two homeless shelter health clinics in Santa Clara County, CA PARTICIPANTS: Currently or recently homeless individuals seeking health care at two homeless shelter health clinics between August 2013 and May 2014. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Demographics, traumatic brain injury incidence and characteristics RESULTS: Findings indicate that TBI history in the homeless population is higher (79.7%) than the general population (12%). Almost half of the population (49.2%) reported that their TBI occurred before the age of 18. 68.2% of participants reported sustaining a TBI with loss of consciousness. TBI due to violence (60%) was lower in this cohort compared to other homeless cohorts but was the main cause of injury regardless of age. Alcoholism was a risk factor for having more TBIs. No differences in TBI profile were found between genders. CONCLUSION: Our findings underscore the need for more research on the lifetime risk factors associated with TBI to prevent and reduce the number of brain injuries in homeless populations.
ABSTRACT
The causes of homelessness are complex and poorly understood. This paper describes the homeless population in Santa Clara County, California in terms of Adverse Childhood Events, Traumatic Brain Injuries (TBIs), and family breakdown. Respondents reported severely traumatic childhoods; 78.7% grew up in a household with a person with drug or alcohol dependence and 64.6% endured psychological abuse as a child. Seventy-six percent of subjects recalled at least one TBI, 58.4% with loss of consciousness. Nineteen percent were in foster care as children and 40.2% reported having someone other than a parent as a primary caregiver. Fifty-three percent felt they had moved too much as children, and 37.5% had experienced homelessness as children. Santa Clara County has both the highest median income and the highest rate of unsheltered homelessness in the nation. Leaders and community members should work together to improve the lives of the home-less and to prevent another generation of homeless people.