Traumatic brain injury (TBI) has long been recognized as a common affliction among U.S. military veterans, with nearly 20 percent of this population affected, predominantly through concussive injuries sustained in service. Despite its prevalence, the far-reaching effects of TBI have remained elusive, obscured by the complexity of its clinical manifestations and the challenges inherent in long-term epidemiological surveillance. Recently, groundbreaking research led by Dr. Mary Jo Pugh, a professor of epidemiology at University of Utah Health and a key investigator at the VA Salt Lake City Healthcare System’s Informatics, Decision-Enhancement and Analytical Sciences (IDEAS) Center of Innovation, has begun to unravel the multilayered consequences of TBI beyond the acute phase.
On August 4, 2025, Dr. Pugh received the Outstanding Research Accomplishment award at the Military Health System Research Symposium, a prestigious honor granted to only two investigators nationwide. The award acknowledges exceptional contributions to medical research funded by the Department of Defense, highlighting the transformative impact of her work in advancing understanding of TBI. Over two decades, Pugh’s research has meticulously characterized the long-term health trajectories of veterans exposed to TBI, revealing a spectrum of previously unrecognized consequences that extend far beyond neurological impairment.
Central to Pugh’s findings is the association of TBI with chronic neurodegenerative disorders such as dementia, a discovery that challenges prior assumptions focused narrowly on cognitive deficits immediately following injury. Her epidemiological analyses have also established significant correlations between TBI and increased risks for substance use disorders, cardiovascular disease, and even malignancies. Perhaps most strikingly, the data indicate that veterans with TBI are at elevated risk for suicide, underscoring the profound psychological toll that such injuries can inflict. These revelations emphasize the necessity for comprehensive, longitudinal approaches to veteran healthcare that address the complex interplay between brain injury and systemic disease.
.adsslot_ClEbhfvLkx{ width:728px !important; height:90px !important; }
@media (max-width:1199px) { .adsslot_ClEbhfvLkx{ width:468px !important; height:60px !important; } }
@media (max-width:767px) { .adsslot_ClEbhfvLkx{ width:320px !important; height:50px !important; } }
ADVERTISEMENT
A pivotal enabler of Pugh’s research has been her ability to harness and integrate massive datasets from both the Department of Veterans Affairs and the Department of Defense. This integration creates an unprecedented repository of linked military service and health outcome data, which includes critical variables such as injury type, exposure to blast weapons, and service history. By blending these formerly siloed data sources, Pugh’s team has opened a new frontier for evaluating the full scope of TBI outcomes—capturing health trajectories that would otherwise remain invisible when examining VA records alone.
“Linking datasets from the Department of Defense and Veterans Affairs provides a treasure trove of information,” Pugh explains, “allowing us to analyze the ripple effects of combat-related injuries with a granularity and duration that was not previously possible.” This fusion is particularly vital for studying Military Occupational Blast Exposure (MOBE), a prevalent but often undocumented risk factor among service members. MOBE’s subtlety and the absence of formal diagnoses have historically impeded recognition and compensation of affected veterans. With enhanced data visibility, Pugh’s research now illuminates how repeated low-level blast exposures contribute to cumulative brain injury risks.
To navigate the massive and intricate datasets involved, Pugh employs a sophisticated analytical approach rooted in complexity theory. This framework transcends traditional linear models by accommodating the dynamic and multifactorial nature of TBI effects, allowing the disentanglement of concussion impacts from overlapping risk factors. Complexity theory-based analysis facilitates the identification of latent patterns and subtle associations within heterogeneous data, thereby revealing long-term health consequences that evade standard statistical methods.
Dr. Matthew Samore, principal investigator of the IDEAS Center and a leading figure in healthcare informatics at University of Utah Health, lauds Pugh’s revolutionary contributions: “Her work provides foundational evidence that is reshaping our understanding of blast injury effects, fundamentally influencing military health policies and clinical care strategies.” Samore underscores the translational significance of the research, noting how these data-driven insights are guiding new protocols to safeguard service members and veterans.
Pugh’s leadership extends to national collaborations as well, notably through her role as head of the Data and Biostatistics Core of LIMBIC, a large-scale research consortium sponsored by the Department of Defense and the Veterans Affairs system. LIMBIC unites almost 40 institutions in a shared mission to investigate the chronic outcomes of brain trauma across an extensive cohort exceeding 2.5 million individuals. This consortium leverages pooled resources and expertise to accelerate discovery and promote standardization in TBI research nationwide.
The implications of Pugh’s work are profound for the veteran community. By delineating clear links between TBI and serious long-term health complications, her research lays the groundwork for preemptive interventions aimed at mitigating downstream morbidity. Early identification of at-risk veterans could enable proactive monitoring, tailored therapies, and support services designed to improve quality of life and reduce premature mortality.
Behind this innovative work is a deep partnership spanning over 80 years between the VA Salt Lake City Health Care System and University of Utah Health. This enduring collaboration has fostered an environment rich in resources and shared expertise, crucial for tackling the complexities of veteran health research. Many VA investigators simultaneously hold faculty appointments at the University of Utah’s Spencer Fox Eccles School of Medicine, which further integrates clinical care with cutting-edge research.
Throughout her career, Dr. Pugh continues to innovate at the intersection of big data analytics, epidemiology, and clinical science. Her insights extend well beyond TBI, demonstrating the power of integrated data systems and advanced analytical tools to transform our grasp of complex disease mechanisms. As the field moves forward, her pioneering approach sets a standard for how health informatics can reveal the hidden narratives of trauma and healing woven into veterans’ lives.
The future of TBI research appears brighter, fueled by Dr. Pugh’s relentless pursuit of knowledge and unwavering dedication to veteran health. With continued expansion of comprehensive data linkages and methodological advancements, the medical community is poised to usher in an era where the silent and long-lasting injuries of war are no longer overlooked but met with informed care and effective prevention.
Subject of Research: Long-term health consequences of traumatic brain injury in U.S. veterans
Article Title: Unveiling the Hidden Aftermath: The Long-Term Impact of Traumatic Brain Injury Among U.S. Veterans
News Publication Date: August 4, 2025
Web References:
https://medicine.utah.edu/faculty/mary-jo-pugh
https://uofuhealth.utah.edu/newsroom/news/2019/10/limbic-grant
Keywords: Head concussions; Traumatic injury; Military science; Dementia; Big data
Tags: clinical manifestations of TBIDepartment of Defense medical researchDr. Mary Jo Pugh achievementsepidemiology of TBIhealth trajectories after TBIlong-term consequences of TBImilitary veterans healthOutstanding Research Accomplishment awardTBI awareness and advocacyTBI in U.S. militarytraumatic brain injury researchVeterans Affairs research contributions