As Black and other non-white folk suffer poorer outcomes following a traumatic brain injury, this establishes a troubling correlation with a greater risk of homelessness for these demographics.
Homelessness has been steadily on the rise in the United States in the years following the start of the COVID-19 pandemic, with more than half a million Americans experiencing homelessness in the last year. In correlation with this, research shows a higher prevalence of traumatic brain injury (TBI) in non-white demographics may leave them more susceptible to homelessness.
Resulting from a blow or multiple blows to the head from a fall or an accident, TBI could be sustained through various circumstances. TBI most commonly occurs while playing sports, during a car accident, or a following a physical assault. Prompt care is crucial to limit the long-term effects of the injury, though it may take more than a year for an injury’s effects on brain function to be fully clear.
TBI can cause brain bleeds that require emergency surgery, but less severe forms of injury may simply require ongoing monitoring to ensure surgery isn’t needed later. Brain imaging is a typical method of identifying the location and nature of an injury in order to form a treatment plan.
According to the Brain Injury Association of America, Black folk are at the greatest risk of experiencing TBI of any minority or non-minority group. This is due to several social and economic factors previously established through existing findings. Black Americans are the most likely to sustain TBI as a result of a violent event and are only second to Indigenous American demographics in the percentage of TBI-related deaths.
While Black Americans with mild-to-severe traumatic brain injuries experience recoveries consistent with non-Black groups, they were found to be less likely to return to their lifestyle prior to injury. Specifically, maintaining employment was reported as a greater challenge to Black Americans living with TBI compared to other demographics.
Studies show that Black and Indigenous women experience abuse within relationships at higher rates without reporting it, leading in-turn to higher rates of TBI. Moreover, these demographics suffer spousal abuse at rates 30-50% higher than their white, Hispanic, and Asian counterparts.
TBI patients often suffer long-term effects such as mood swings, anger, and violent outbursts. These behaviors have the potential to complicate relationships and interactions with others, leaving affected individuals isolated. Likewise, TBI has a strong correlation with homelessness, holding such a deep connection that researchers are unsure which is the more prevalent catalyst to the other. Accordingly, data shows that homelessness itself also puts individuals at greater risk of suffering TBI, as 7 to 11% of North Americans suffer TBI in their first year of homelessness.
Both Black Americans and Indigenous Americans are similarly overrepresented in the homeless population at rates of 3 to 1 and 5 to 1, respectively. Data from a study published by Lancet Public Health shows that over half of all homeless individuals have suffered TBI. This study utilized compiled metrics across seven countries, including the US and Canada. Each issue compounds and perpetuates the other to an indistinguishable degree, though a significant connection between these two factors remains.
This context renders homelessness a public health issue as much as a social one. Hospitals and medical centers such as Baylor Scott & White Institute of Dallas provide specialized rehabilitation services for those suffering from TBI. Ranked 14th nationally, Baylor Scott & White reports a low rate of readmission for patients; however, lack of necessary follow-up care is noted as a major concern for Black TBI patients.
As lower rates of rehabilitation could be attributed as a major cause of poorer psychosocial, functional, and employment-based outcomes in Black Americans that have sustained TBI, accessibility to healthcare is highlighted as a significant factor. Black Americans are uninsured at a higher rate than their white counterparts, as the uninsured rate is 10.8% for Black folk compared to 7.2% for whites. Even when Black people do receive medical care, it is often lower quality than what can be expected by white folk.
As 7 out of 10 Black Americans attest to poorer healthcare treatment, the demographic is also more likely to report an inability to pay medical bills. Medical debt is listed as a major contributor to homelessness, as it can ensure that Americans remain unhoused for a longer period of time. Working-class Black Americans who suffer from TBI are effectively forced deeper into poverty through medical debt, if not already laden with the challenges presented in going untreated.
Observations on potential outcomes of Black Americans with TBI convey several pipelines to homelessness. As poverty is on the rise due to several economic factors in the United States, vulnerabilities across demographics in the working class become more apparent. Hitting Black Americans the hardest, the economic crisis continues to spur a greater public health disaster among non-white demographics through both direct and indirect means.
If you or a loved one suffers from the effects of TBI and are seeking help or resources, visit https://www.biausa.org/find-bia/states/texas/resources-support