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The Contribution of Neighborhood Characteristics to Psychological Symptom Severity in a Cohort of Injured Black Men



Traumatic injury is not evenly distributed by race and class in the USA. Black men are marginalized in the society, often reside in disadvantaged neighborhoods, and are at higher risk for injury mortality and ongoing physical and psychological problems following injury. Post-traumatic stress disorder (PTSD) and depressive symptom severity are among several problematic and disabling conditions faced by injury survivors. While much research has examined individual factors that lead to increased post-injury psychological symptom severity, the contribution of the social and physical environment has been relatively understudied.


To examine the contribution of neighborhood characteristics to PTSD and depressive symptom severity in Black men following traumatic injury.


Prospective cohort study. Participant data were linked via GIS to neighborhood characteristics (constructs established by factor analysis) to spatially model factors associated with increased post-injury psychological symptom severity using a GEE regression analysis, adjusting for injury mechanism and severity, age, and insurance.


Four hundred fifty-one adult Black males hospitalized for traumatic injury.


The 4 constructs were neighborhood disconnectedness, concentrated disadvantage/deprivation, crime/violence/vacancy, and race/ethnicity. High depressive and PTSD symptom severity was reported by 36.8% and 30.4% of participants, respectively. Higher PTSD symptom severity was associated with crime/violence/vacancy, and higher depressive symptom severity was associated with neighborhood disconnectedness. PTSD and depressive symptom severity were associated with intentional injury mechanisms and Medicaid/no insurance. Higher injury severity was associated with depressive symptoms.


Neighborhood characteristics are associated with psychological symptom severity after injury.

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Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number R01NR013503 (PI: Richmond), the Office of Nursing Research (ONR) at the University of Pennsylvania School of Nursing, and the Hillman Scholars in Nursing Innovation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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All authors contributed to the study conception and design. Dr. Bruce and Dr. Richmond conceptualized the study and acquired data for the study. Mr. Robinson oversaw data management and initial coding of data. Dr. Bruce analyzed data under the supervision of Dr. Richmond, Dr. Wiebe, and Dr. Shults. Dr. Bruce wrote the original draft of this manuscript. All authors reviewed, edited, and approved the final manuscript.

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Correspondence to Therese S. Richmond.

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Bruce, M.M., Robinson, A.J., Wiebe, D.J. et al. The Contribution of Neighborhood Characteristics to Psychological Symptom Severity in a Cohort of Injured Black Men. J. Racial and Ethnic Health Disparities (2022).

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