The Contribution of Neighborhood Characteristics to Psychological Outcomes After Serious Injury in a Cohort of Black Men: A Multi-Methods Study

My dissertation examines how neighborhood characteristics contribute to psychological outcomes of Black men after serious injury. My dissertation is composed of three studies, using qualitative, quantitative, and geospatial methods.

In the first study, published in the Journal of Racial and Ethnic Health Disparities, I use thematic qualitative analysis to explore injured Black men’s motivations and concerns about participating in a research study. I find that injured Black men chose to enter the study for a variety of reasons but predominantly for human connection. Participants disclosed that being in the study afforded them the opportunity to talk about the injury experience and its aftermath. Broadly, all patients desire human connection and caring treatment when they are injured or ill. The high value that study participants placed on human connection and therapeutic care introduces the possibility that injured Black men potentially are not receiving such care and are potentially experiencing dehumanization.

In the second study, I quantitively examine neighborhood characteristics associated with post-injury PTSD and depressive symptom severity of seriously injured Black men. I find that “neighborhood disconnectedness” was associated with depressive symptom severity, and “crime, violence, and vacancy” was associated with PTSD symptom severity. In addition, I find that reporting Medicaid coverage or no health insurance strongly predicted higher depressive symptom severity and, to an even greater extent, higher PTSD symptom severity.

In the third study, I qualitatively explore Black men’s perceptions of their environment during recovery from serious injury. I identify four themes in injured men’s narratives: challenges to recovery, feeling unsafe, efforts to increase safety, and resources for recovery. Participants described feeling viewed in nonempathetic ways due to the mechanism of their injuries or their identity as injured Black men. These findings highlight the precarity of Black men in our society and in our health system, and the importance of the role of community resources that can support injured men’s recovery within their neighborhoods.

Marta Bruce is a 2020 Doctoral Recipient in the School of Nursing. She is a Registered Nurse at the Neuro Intermediate Care Unit at the Hospital of the University of Pennsylvania.

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