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Association between traumatic brain injury and prison charges: a population-based cohort study


Background — Traumatic Brain Injury (TBI) is a serious hidden health issue disproportionately affecting people who experience incarceration.

Objective — We examined the association between TBI and serious disciplinary charges among men and women sentenced by the courts to terms of two or more years.

Methods — The study originated in Ontario, Canada and used linked administrative health and correctional data. The cohort included adults experiencing their first federal sentence between 1998 and 2011 (N = 12,038). We examined disciplinary charges incurred 2 years post-sentence commencement. TBI was defined using the International Classification of Diseases (ICD-9 and ICD-10) diagnostic codes. Robust Poisson regression was conducted to assess the association between TBI and disciplinary charges.

Findings — The prevalence of TBI for the full sample was 13.2%. One-third of adults with a recent TBI had a serious disciplinary charge. The unadjusted risk of incurring a serious charge for those with a history of TBI was 39% higher than those with no history of TBI (CI: 1.29-1.49). The adjusted risk was 1.14 (CI: 1.06-1.22).

Conclusions — TBI is a serious health concern that makes it difficult for incarcerants to adjust to prison. Additional support/resources are needed to support those with histories of TBI.



Matheson FI, McIsaac KE, Fung K, Stewart LA, Wilton G, Keown LA, Nathens AB, Colantonio A, Moineddin R. Brain Inj. 2020; 34(6):757-63. Epub 2020 Apr 23.

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