Homeless in America: injuries treated in US emergency departments, 2007–2011
Open accessAbstract
Despite being a high-risk population, epidemiological research about injuries among homeless individuals is limited. We sought to describe injury characteristics among individuals identified as homeless in the National Electronic Injury Surveillance System (NEISS), and to compare them to age- and sex-matched controls. We searched text narratives for all patients with product-related injuries who presented to NEISS emergency departments from 2007 to 2011 to identify homeless cases (N = 268). A random sample of 2680 age- and sex-matched controls was identified for the same time period. The incident location differed between groups, and the mention of substance use was significantly more common among homeless cases than controls. The body part injured differed significantly between cases and controls for all age groups, with the exception of older adults. Among homeless cases, injuries occurred most frequently to the lower extremities, and sprains/strains, contusions/abrasions and burns were most common. Additional research on injury among homeless individuals is warranted in order to identify meaningful preventive strategies for this at-risk population.
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The poor health of homeless people is multifactorial, including risk factors that increase homelessness risk and are associated with poor health outcomes, such as early life poverty and mental health and substance misuse disorders.
“The reasons for this are multifactorial and include risk factors that increase individuals’ risk for homelessness and are associated with poor health outcomes, such as early life poverty52 and mental health and substance misuse disorders.49,53”
From The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations (2014) · cites this paper as [53]
The Introduction reports elevated rates of mental illness and substance use disorders among homeless people and says psychiatric illness or substance abuse commonly precipitates hospital care. It does not establish that these disorders increase the risk of becoming homeless. Early-life poverty is attached to citation 52, not to this source. (LLM, conf=0.84)
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“…homelessness are more likely to have severe infections (Takahashi et al., 2007), acute illnesses (Rickards et al., 2010), mental disorders (Latimer et al., 2017), substance-related disorders (Magwood et al., 2020), injuries (Mackelprang et al., 2014), and suicidal behaviors (Gentil et al., 2021).”
Prevalence of Housing Insecurity in Survivors of Traumatic Injury
Vera, L., Reed, K. K., Rose, E. D., Deyampert, L., Woodard, J., Cortes, J., Henry, A., Thompson, A. N., Williams, K. N., Blount, Q., et al. (2022) · The American Surgeon · doi:10.1177/00031348221101575 · Cited by 3 · see citing works
Understanding drivers of fire risk with people experiencing homelessness
Orton, C. M., Gannon, M., Mešić, A., Chambers, M., Enzian, L., Pham, T. N., & Stewart, B. T. (2025) · Burns · doi:10.1016/j.burns.2025.107482 · Cited by 3 · see citing works
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The use of health services by women living homeless in Madrid, Spain
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The role of a credit trap on paths to homelessness in the Czech Republic
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The emergency department, injury control, and safety promotion
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Orton, C. M., Pacleb, M. I., Machacha, T. M., Marincasiu, C., Moore, M., & Stewart, B. T. (2025) · Journal of Burn Care & Research · doi:10.1093/jbcr/iraf082 · Cited by 1 · see citing works
The unhoused burn patient: an unmet need for prevention, treatment, and recovery
Sen, S., Heard, J., Palmieri, T. L., & Romanowski, K. S. S. (2025) · Burns Open · doi:10.1016/j.burnso.2025.100440 · Cited by 1 · see citing works
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“Diagnozy dotyczące urazów oraz rozpoznania związane z używaniem alkoholu lub innych substancji psychoaktywnych oraz rozpoznania zaburzeń psychicznych były wiodącymi również w badaniach innych badaczy [37, 42-46].”
BackgroundResultSalhi, B. A., & Doran, K. M. (2021) · Springer eBooks · doi:10.1007/978-3-030-65672-0_14 · Cited by 1 · see citing works
PERCEPTIONS OF THE HOMELESS TOWARD NONPROFIT HUMAN SERVICE PROVIDER
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Comprehensive Management of the Lower Extremity in the Homeless Patient
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Understanding Youth Homelessness
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Methodological Approach to the Study
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Epidemiology of Burn Injury Among People Experiencing Homelessness: A Scoping Review
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“These findings emphasise the necessity of integrated medical, psychiatric and social interventions to improve outcomes in this vulnerable population [10-14].”
- Authors
- Mackelprang, J. L., Graves, J. M., & Rivara, F. P.
- Affiliations
- University of Washington (US)
- Corresponding author
- Mackelprang, Jessica L.
- Venue
- International Journal of Injury Control and Safety Promotion
- Publisher
- Informa UK Limited
- Published
- 2013-09-06
- Volume
- 21
- Issue
- 3
- Pages
- 289-297
- ISSN
- 1745-7300 (ISSN-L)
- 1745-7319
- PMC
- PMC3947742
- OpenAlex
- W2070570035
- Cited by
- 63
- References
- 42
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 7 · 2022: 7 · 2021: 13 · 2020: 4 · 2019: 4 · 2018: 4 · 2017: 2 · 2016: 3 · 2014: 3 · 2013: 2 · 2012: 3
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Injury Control and Safety Promotion (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion)
- Funders
- U.S. Consumer Product Safety Commission
- National Institutes of Health (2t32hd057822-16)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32, HD057822)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- homelessness, injury epidemiology, emergency department visits, substance use, injury location, lower limb injuries, burns, sprains and strains, injury prevention, vulnerable populations
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Emergency Service, Hospital, Female, Ill-Housed Persons, Humans, Infant, Infant, Newborn, Male, Middle Aged, United States, Wounds and Injuries, Case-Control Studies, Young Adult
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