Schroeder Krista, Noll Jennie G, Henry Kevin A, Suglia Shakira F, Sarwer David B
Temple University College of Public Health - Department of Nursing, 3307 North Broad Street, Philadelphia, PA 11940, USA.
Penn State College of Health and Human Development - Department of Human Development and Family Studies, 325 Health and Human Development Building, University Park, PA 16802, USA.
Prev Med Rep. 2021 Jul 20;23:101501. doi: 10.1016/j.pmedr.2021.101501. eCollection 2021 Sep.
Trauma is a response to a deeply distressing or disturbing event, such as sexual assault, violent crime, or childhood abuse. Trauma has impacted the majority of Americans, with racial/ethnic minority and socioeconomically disadvantaged populations being disproportionately affected. Extensive evidence demonstrates trauma's harmful effects on physical and psychosocial functioning and healthcare costs. Over the past decade, there has been greater recognition of the need to respond to trauma across various care delivery and program settings. Such recognition led to development of trauma-informed care, an approach that acknowledges trauma's widespread impact and delivers care in a manner to promote healing and avoid re-traumatization. To date, trauma-informed approaches have been applied to clinical interventions, social programs, and community organizations. However trauma-informed approaches have not been widely applied to the built environment. Here, we propose the concept of a trauma-informed neighborhood. The idea of a trauma-informed neighborhood has not been elucidated in public health or medicine, yet merits attention because physical aspects of the neighborhood environment, such as lighting, traffic density, noise, and greenspace, may either trigger trauma or promote healing for individuals and communities. Research using geospatial, population health, and community-engaged approaches is needed and could build from the existing literature on how the built environment impacts mental health. Evidence would have direct implications for public policy and urban planning, particularly for neighborhoods where residents bear a disproportionate trauma burden. Until the built environment is routinely included in trauma-informed efforts, a key setting that influences trauma recovery, health, and well-being will remain overlooked.
创伤是对极具痛苦或令人不安的事件的一种反应，比如性侵犯、暴力犯罪或童年期受虐。创伤影响了大多数美国人，少数族裔和社会经济地位不利的人群受到的影响尤为严重。大量证据表明创伤对身体和心理社会功能以及医疗成本具有有害影响。在过去十年中，人们越来越认识到需要在各种护理服务和项目环境中应对创伤。这种认识促使了创伤知情护理的发展，这是一种承认创伤广泛影响并以促进康复和避免再次创伤的方式提供护理的方法。迄今为止，创伤知情方法已应用于临床干预、社会项目和社区组织。然而，创伤知情方法尚未广泛应用于建筑环境。在此，我们提出创伤知情社区的概念。创伤知情社区的概念在公共卫生或医学领域尚未得到阐明，但值得关注，因为社区环境的物理方面，如照明、交通密度、噪音和绿地，可能会引发创伤，也可能促进个人和社区的康复。需要采用地理空间、人群健康和社区参与方法进行研究，并且可以借鉴现有关于建筑环境如何影响心理健康的文献。证据将对公共政策和城市规划产生直接影响，特别是对于居民承受不成比例创伤负担的社区。在建筑环境被常规纳入创伤知情工作之前，一个影响创伤恢复、健康和福祉的关键环境将仍然被忽视。
