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Environment Key to Injury Recovery

Black men are disproportionately impacted by injuries in the United States. This disparity is glaring given that injury is one of the top ten causes of death. Data show that injured Black men from disadvantaged neighborhoods experience higher injury mortality, years of life-expectancy loss, and psychological symptoms that persist after initial wounds have been treated.

While much research has examined individual characteristics that predict poor recovery from injury, fewer studies have focused on social and physical features of the environment and how they may impact the recovery of injury survivors.

A new study from the University of Pennsylvania School of Nursing (Penn Nursing) focuses on injured Black men’s perceptions of their injury recovery environments, including how unsafe they feel and the varying availability of resources for recovery within their neighborhoods. The findings emphasize the importance of the neighborhood environment in recovery after injury and the role of social support and resource allocation to injury survivors in the aftermath. The study has implications for the need for changes that could better support patients dealing with the consequences of serious injuries within the context of neighborhood-level adversity.

“Our findings raise important considerations on the inpatient and discharge experiences of injury survivors. Survivors expressed significant barriers to recovery, and the importance of their social networks but limited resources available to them. Our participants expressed a deep human need to be listened to and treated with respect,” says Marta Bruce, PhD, RN, of Penn Nursing and an intensive care nurse at the Hospital of the University of Pennsylvania, lead author of the article.

“This research points to the importance of intervention at the critical window of the inpatient experience prior to discharge for increased empathetic communication, better coordination of social work and mental health services, and better planning for the challenges of discharge raised by our participants,” says Therese S. Richmond, PhD, RN, FAAN, Andrea B. Laporte Professor of Nursing and Associate Dean for Research & Innovation at Penn Nursing, and co-author of the study. “Clinicians should consider that an injury represents a traumatic disruption in survivors’ lives and that the journey to recovery is affected by social and environmental factors outside the walls of the hospital.”

The study’s findings have been published in an article, “Injured Black Men’s Perceptions of the Recovery Environment,” in Social Science & Medicine and is available online. Coauthors of the article include Connie M. Ulrich, PhD, RN, FAAN, Lillian S. Brunner Chair in Medical and Surgical Nursing, Professor of Nursing, and Professor of Medical Ethics and Health Policy; and Jessica Webster, MS, LPC, both of Penn Nursing.


The study 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.