Neighborhood poverty prospectively predicts PTSD symptoms six-months following trauma exposure

Abstract

Individuals living in areas with high rates of poverty are disproportionately affected by posttraumatic stress disorder (PTSD). Despite this association, little is known about how neighborhood poverty rates impact risk for PTSD development. In the current prospective study, we determined the relationship between neighborhood poverty rate and PTSD symptoms 6-months after experiencing a traumatic event in a sample of varied race, gender, and socioeconomic status. Participants (N = 252) were enrolled in a hospital emergency department after experiencing a traumatic event. Demographic information (including zip code of residence), baseline PTSD symptoms, and baseline trauma history was assessed in the emergency department. PTSD symptoms were again assessed 6-months posttrauma. Neighborhood poverty rate was determined using the American Community Survey. Correlation analyses revealed that neighborhood poverty was significantly associated with baseline PTSD symptoms (r = 0.181, p = 0.004) and PTSD symptoms 6-months posttrauma (r = 0.163, p = 0.009). A regression analysis controlling for baseline trauma exposure, clinician-rated trauma severity, and individual socioeconomic status demonstrated that neighborhood poverty predicted PTSD symptoms six-months posttrauma (R² = 0.099, B = 0.15, p = 0.04), but this relationship was no longer significant when baseline PTSD symptoms was added as an additional covariate (R² = 0.304, B = 0.07, p > 0.05). Overall, results suggest that neighborhood poverty generally increases PTSD symptom severity, and the context in which an individual lives should be considered when conceptualizing risk for PTSD.