Tuesday, February 05, 2008

Head Trauma--Surprising Connections

Last Tuesday's edition of The Wall Street Journal published a frontpage article on the connection between head injuries and various social issues ( "Studies Cite Head Injuries As Factor in Some Social Ills," by Thomas M.Burton, A1, January 29, 2008).

It seems that medical researchers discern a link between a number of social problems and sometimes long-forgotten head trauma. The list of problems that may be connected to earlier head injuries includes mental illnesses, alcoholism, drug abuse, learning disabilities and chronic homelessness.

The U. S. Centers for Disease Control and Prevention estimates that 5.3 million Americans suffer from long-term disabilities that are related to brain injuries. The connection of such social and personal challenges to brain trauma often go unrecognized. Reserachers discovered high incidence of forgotten or unreported head injuries in working with patients dealing with a whole range of behavioral and social problems.

The source of head traumas include typlical experiences that occur and are forgotten, such as bike and car accidents, sports-related concussions and childhood accidents or abuse.

A research team at the Brain Injury Research Center at Mount Sinai School of Medicine in New York conducted assessments of arouind 100 homeless men in New York City. The study found that 82% of the men reported brain injuries in childhood, primarily due to parental abuse. In an expanded study of public education programs designed for students with learning disabilities, researchers discovered that 50% of the children had suffered some sort of head trauma at some point in their lives.

The story reminded me of two conversations I've had with colleagues, one in Seattle and one here in Dallas.

During a trip to Seattle to study effective models of permanent supportive housing (thanks to the support of the Corporation for Supportive Housing), I learned that all of the residents in a 75-unit housing development designed for some of the most fragile and expensive homeless persons in the city had experienced head trauma.

Here in Dallas, Dr. Joel Feiner, the director of psychiatric services at our VA Hospital, told me that 85% of his homeless patients suffer from post traumatic stress disorder as a result of traumatic experiences prior to their entry into military service. Most were abused as children.

Interesting findings and experiences.

The evidence is growing. There are reasons back of the homelessness we observe in our communities. As with just about everything human, kindness and understanding go a long way in leading us toward correct and effective responses to our neighbors who suffer and live in great difficulty through no fault of their own.

[The Wall Street Journal article can be read at: http://online.wsj.com/article/SB120156672297223803.html.



Charles said...

Not to undercut your conclusion, which I support for many other reasons, but did they have a value for how many people not needing treatment had head trauma? Seems like I remember a lot of us getting pretty severe knocks on the noggin as kids.

Greg said...

A resource you might find interesting is a place called Brainplace.com. Started by Dr. Daniel Amen, he does SPECTs on folks and at one time, had the largest library of brain spects in the world. He has been teaching, educating, preaching about brain injuries for over 15 years.

Pogue said...

According to Robert Brookshire, author of Introduction to Neurogenic Communication Disorders-6th Edition, one of the risk factors for traumatic brain injury (TBI)is a history of TBI. A probability of a second TBI is three times greater for someone who has sustained a previous TBI. A probability of a third TBI for an individual with two previous is eight times greater.

Although some of us took some hard knocks to the noggin as kids. Our social and economic environment may have protected us.

TBI history is just one factor in the mix. Other risk factors include include substance abuse, poor school adjustment and social history, lower socioeconomic status,Type A personality, and being male.

owldog1 said...

Tongue n cheek Now I know why my son is making some bad choices, he had several diagnosed concussions

Larry James said...

Thanks for the posts. As a matter of fact, the studies referenced in the WSJ article noted the fact that lots of kids experience head trauma and suffer no long-term ill effects it seems (I believe it is like 85% who suffer such have no problems). Owldog, that said, it is a reality that youth like your son--a great kid, I might add--could suffer now due to concussions back then. Football is brutal, plus just growing up!

Karen Shafer said...

Pogue makes a good point:

'Although some of us took some hard knocks to the noggin as kids. Our social and economic environment may have protected us.'

I rode horses throughout my childhood and adolescence, and consequently had many falls. We didn't use helmets until the last few years, and then only in horse shows. But I always had good medical care.

I have a homeless female friend downtown who had a serious head injury as a child during which she lost a piece of her skull. She was supposed to receive a steel plate to cover the space left by the missing piece of bone, but there was no money or health insurance for it. Consequently, there is still an opening where that piece of bone should be. Now she has many difficulties -- headaches, memory problems, etc., in addition to being homeless.

Connections between head injuries, health care within families, homelessness? There's no doubt about it in my mind. My friend above is only one example among so many. Very many people I've met on the street appear to have these issues.

Anonymous said...

As you say, a lot of head injury accidents come about due to past/forgotten incidents whereby no obvious damage was identified at first, but developed over time and hence became very serious.

If anyone has any doubts about a head injury, they must contact a doctor - and if they feel like they have received some poor advise, contact a solicitor to see about compensation.