Neighborhood Disadvantage and Neurobehavioral Symptoms in Veterans With mTBI

A study published in the Journal of Head Trauma Rehabilitation investigated how neighborhood disadvantage affects neurobehavioral symptom severity among veterans with mild traumatic brain injury (mTBI), and whether symptom burden is compounded among underrepresented racial and ethnic groups living in highly disadvantaged areas.

The analysis included 58 698 veterans who received a clinician-confirmed mTBI diagnosis between 2014 and 2020 and completed the Neurobehavioral Symptom Inventory (NSI) as part of their comprehensive traumatic brain injury evaluation. Researchers used national Area Deprivation Index (ADI) scores to assess neighborhood disadvantage and latent variable regression to evaluate the relationship between ADI, race/ethnicity, and symptom domains—specifically vestibular, sensory, mood-behavioral, and cognitive.

Results indicated that greater neighborhood disadvantage was significantly associated with more severe symptoms across all domains, particularly sensory and mood-behavioral (β = 0.07–0.16 and β = 0.06–0.15, respectively). These associations remained after adjustment for sociodemographic, psychiatric, and injury-related factors. However, no interaction effect was observed between race/ethnicity and neighborhood disadvantage, indicating that the combined influence of these factors did not exacerbate symptoms beyond their individual effects.

The study highlights the independent roles of social environment and racial/ethnic disparities in mTBI recovery and underscores the importance of addressing social determinants of health, such as neighborhood conditions, in both research and care strategies for veterans with mTBI.

Reference

Kinney AR, Bahraini NH, Schneider AL, et al. Relationships between neighborhood disadvantage, race/ethnicity, and neurobehavioral symptoms among veterans with mild traumatic brain injury. J Head Trauma Rehabil. 2025;40(2):65-75. doi:10.1097/HTR.0000000000001016