Nearly one in five U.S. veterans have experienced a traumatic brain injury (TBI), mostly in the form of a concussion. Now, the full long-term health consequences of TBI are starting to be uncovered, thanks in large part to the work of Mary Jo Pugh, PhD, RN, professor of epidemiology at University of Utah Health and investigator with the Informatics, Decision-Enhancement and Analytical Sciences (IDEAS) Center of Innovation at the VA Salt Lake City Healthcare System.
On August 4, Pugh won an Outstanding Research Accomplishment award at the 2025 Military Health System Research Symposium for her TBI research. The award recognizes individual investigators who have recently made outstanding contributions to medical research via work funded by the Department of Defense. Pugh is one of only two investigators nationwide to receive this honor.
Pugh’s work revealed that TBI is associated with many long-term health consequences that were previously unknown, including dementia, substance use disorder, and even cardiovascular disease. TBI is also linked to higher risk of suicide and cancer. Uncovering these patterns of risk is a first step toward preemptive interventions to help veterans with TBI stay healthy.
Key to her work is Pugh’s ability to uncover patterns hidden within big data. Her work helped integrate health data between the VA and the Department of Defense—an essential step to understanding how TBI acquired during military service can impact health after someone leaves the military.
“This linkage is invaluable because it allows us to analyze long-term health outcomes while incorporating crucial details from military service—such as injury characteristics and blast exposures—that are missing from VA data alone,” Pugh says.
“This ‘gold mine’ of data has enabled rapid and critical surveillance of Military Occupational Blast Exposure (MOBE) from large weapons,” she adds, “which is vital because many service members with MOBE do not have a specific documented injury or diagnosis, which is essential to demonstrate service connection for disability claims.”
Pugh leads the Data and Biostatistics Core for a national research consortium called LIMBIC, a DoD- and VA-funded group that brings together nearly 40 organizations to study the chronic effects of brain trauma in a cohort of over 2.5 million people.
To spot new patterns within this data, Pugh uses a strategy called complexity theory. This method of data analysis allows her to disentangle the effects of concussion from other contributors to health, finding long-term health outcomes that other analyses don’t detect.
Matthew Samore, MD, principal investigator of the IDEAS Center and the VA Consortium for Healthcare Informatics Research, says that Pugh’s research has had fundamental impacts. “Dr. Pugh’s contributions of foundational knowledge about the detrimental effects of blast exposure have been instrumental in shaping policy and response,” says Samore, who also serves as division chief of epidemiology at U of U Health.
“I am incredibly proud of our work,” Pugh adds. “This award validates the exceptional work of my team over the past 20 years.”
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The VA Salt Lake City Health Care System and University of Utah Health have an 80-year-long partnership, dating back to the conclusion of World War II. That partnership includes a robust, long-standing tradition of research collaboration that enhances both institutions' service to their local and larger communities. Many VA researchers hold research and clinical appointments at University of Utah Spencer Fox Eccles School of Medicine.