Impact of Biological, Clinical, and Social Determinants on Trauma and Trauma Outcomes

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PROJECT SUMMARY / ABSTRACT This T32 grant, Impact of Biological, Clinical, and Social Determinants on Trauma and Trauma Outcomes, will provide the training and mentoring to create the next generation of physician scientists. Physician-scientists are a critical element of the workforce necessary to improve the health of patients. Injuries and deaths from traumatic injury represent the major cause of death and impaired function among people under the age of 44. This morbidity and mortality creates a disproportionate drain on healthcare resources due to the typical young age of the trauma patient. Additionally, new advances in identifying the scope of chronic traumatic encephalopathy (football players' brain injury) show the need for increased investment in the basic science of trauma. Trauma also disproportionately affects underserved minority patients, resulting in increased healthcare disparities in the United States. This highlights the need for scientists who will lead studies to improve our understanding of and develop interventions to reduce disparities in trauma care, risk of interpersonal violence (child abuse, intimate partner violence, elder abuse) leading to trauma, and social determinants and trauma. This competing renewal will build on the success of the prior ten years of funding. These successes include effective recruitment of minority physicians into the program, 112 publications authored by 17 trainees, including 54 first-author publications. Some of the significant changes in the new application include inclusion of health services and population sciences faculty mentors to support and mentor trainees increasing interest in these areas of research related to causes and outcomes of traumatic events. This grant specifically requests funding for two postdoctoral fellows for two years of training, a formula which has proven successful since inception of this training program. The Executive Committee works closely with the individual trainees to identify mentors whose research matches the interests of the trainees. All of our prior trainees have been drawn from the residency programs at Boston Medical Center, the largest safety net hospital in New England. There is exceptional institutional commitment manifest by the support for the recruitment and retention of minority physicians and trainees with disabilities. The productivity of trainees both during and after their participation in this fellowship demonstrate that we have prepared our trainees for academic careers.