Childhood trauma and neighborhood disorder influence post-injury recovery in urban Black men

A new Penn Nursing study published in the Journal of Urban Health reveals that both Adverse Childhood Experiences (ACEs) and perceived neighborhood disorder significantly impact the mental health of Black men in Philadelphia following serious traumatic injuries. The Penn Nursing study highlights the critical role of social and environmental factors in post-injury recovery.

"This research underscores the profound and lasting impact of social determinants of health on individual well-being," says lead author Therese Richmond, PhD, RN FAAN, the Andrea B. Laporte Professor of Nursing in the Department of Biobehavioral Health Sciences. "Our findings demonstrate that addressing both childhood trauma and the realities of living in neighborhoods with high levels of perceived disorder is crucial for improving the mental health and overall recovery of Black men after injury."

The study analyzed data from 414 Black men who sustained acute physical injuries requiring hospitalization. Researchers examined the combined influence of ACEs and neighborhood characteristics, including perceptions of disorder and objective measures of social and economic disadvantage, on post-injury outcomes such as PTSD, depression, sleep quality, and return to work.

Perceiving neighborhood disorder and feelings of fear and insecurity, emerged as a significant predictor of PTSD and depression after injury. This emphasizes the importance of considering an individual's history of trauma along with the ways in which they experience their local environment and the social and economic factors that contribute to how they feel during the process of recovery."

Sara F. Jacoby, PhD, MPH, MSN, FAAN, study's senior author, the Calvin Bland Faculty Fellow and Associate Professor of Nursing in the Department of Family and Community Health

The study highlights the urgent need for interventions that address the complex interplay of ACEs and neighborhood environments to improve post-injury outcomes among Black men. It points to the potential of interventions for preventing ACEs, improving neighborhood conditions, and addressing the impact of recovering in neighborhoods where residents perceive high levels of disorder.

This research was supported by the Centers for Disease Control and Prevention (R49 CE003083) and by the National Institutes of Health (R01NR013503). Co-authors include Ryan Quinn and Augustine Cassis Obeng Boateng (both from Penn Nursing); Anna Duan (Penn's Weitzman School of Design); Christopher Morrison, PhD, (Columbia University School of Public Health); and Nancy Kassam-Adams, PhD, (Children's Hospital of Philadelphia).