Open AccessHealth Determinants among North Americans Experiencing Homelessness and Traumatic Brain Injury: A Scoping Review
Author(s) -
K Zeiler,
Alwyn Gomez,
François Mathieu,
Frederick A. Zeiler
Publication year - 2021
Publication title -
neurotrauma reports
Language(s) - English
Resource type - Journals
ISSN - 2689-288X
DOI - 10.1089/neur.2021.0010
Subject(s) - cinahl , traumatic brain injury , medicine , gerontology , occupational safety and health , mental health , population , intervention (counseling) , poison control , injury prevention , psychiatry , medline , psychology , psychological intervention , environmental health , political science , pathology , law
Traumatic brain injury (TBI) in those experiencing homelessness has been described in recent literature as a contributor to increased morbidity, decreased functional independence, and early mortality. In this systematically conducted scoping review, we aimed to better delineate the health determinants-as defined by Health Canada/Centers for Disease Control and Prevention (CDC)-associated with TBI in North Americans experiencing homelessness. BIOSIS, MEDLINE, CINAHL, EMBASE, SCOPUS, and Global Health were searched from inception to December 30, 2020. Gray literature search consisted of relevant meeting proceedings. A two-step process was undertaken, assessing title/abstract and full articles, respectively, based on inclusion/exclusion criteria, leading to the final 20 articles included in the review. Data were abstracted, assessing the aims, literature quality, and bias. Five health determinants displayed strong associations with TBI in those North Americans experiencing homelessness, including male gender, poor physical environment, negative personal health behaviors, adverse childhood experiences (ACEs), and low educational attainment. In those studies displaying a comparator population experiencing homelessness without TBI, the TBI group displayed trends toward increased disparity in Health Canada and CDC defined health determinants. Most studies suffered from moderate limitations. There are associations between male gender, poor physical environment, negative personal health behaviors, ACEs, and limited education in those experiencing homelessness and TBI. The results suggest that those experiencing homelessness with TBI in North America suffer poorer health consequences than those without TBI. Future research on TBI in North Americans experiencing homelessness should focus on health determinants as potential areas for intervention, which may lead to improved outcomes for those experiencing both homelessness and TBI.