Neighborhood Characteristics and Outcomes After Traumatic Brain Injury

Corrigan JD, Bogner JA. Neighborhood characteristics and outcomes after traumatic brain injury.ObjectiveTo determine the extent to which characteristics of a person's neighborhood contribute to outcomes after traumatic brain injury (TBI).DesignProspective cohort.SettingA specialized brain injury unit providing acute rehabilitation care.ParticipantsA consecutive sample of participants (N=200) in the Traumatic Brain Injury Model Systems (TBIMS) longitudinal study: 100 participants were 2 years postinjury, and 100 participants were 5 years postinjury.InterventionsNot applicable.Main Outcome MeasuresU.S. Census Bureau block group descriptors of economic and social characteristics and initial and follow-up data from the TBIMS national dataset including the Glasgow Outcome Scale–Extended (GOS-E) and Satisfaction With Life Scale (SWLS).ResultsEconomic and social characteristics of a person's neighborhood accounted for additional variance in outcomes beyond what could be accounted for by individual characteristics, including demographic, premorbid, and injury-related measures; concurrent measures of functioning; and the persons's perception of environmental influences. Individual characteristics predicted a substantial proportion of the variance in the GOS-E (69%); neighborhood characteristics contributed an additional 1.5%. Individual characteristics predicted 33.3% of the variance in SWLS, with neighborhood characteristics accounting for an additional 6.9%.ConclusionsFor both outcomes, a small but important proportion of the variance accounted for by neighborhood indices was unique to these environmental influences and was not accounted for by individual indices, including concurrent measures of functioning and the individual's perception of environmental influences. Further investigations of how neighborhood factors affect outcomes after TBI are warranted.