Racial and Ethnic Disparities in Employment Outcomes for Persons With Traumatic Brain Injury: A Longitudinal Investigation 1-5 Years After Injury

• Published in: PM & R 2011-12, Vol.3 (12), p.1083-1091
• Main Authors: Arango-Lasprilla, Juan Carlos, PhD, Ketchum, Jessica M., PhD, Lewis, Allen N., PhD, Krch, Denise, PhD, Gary, Kelli W., PhD, Dodd, Brett Anthony, BA
• Format: Article
• Language: English
• Subjects: Adult; African Americans - statistics & numerical data; Brain Injuries - ethnology; Brain Injuries - rehabilitation; Employment - statistics & numerical data; European Continental Ancestry Group - statistics & numerical data; Female; Hispanic Americans - statistics & numerical data; Humans; Male; Odds Ratio; Physical Medicine and Rehabilitation
• ISSN: 1934-1482; 1934-1563
• DOI: 10.1016/j.pmrj.2011.05.023

Objective To determine whether differences exist in employment rates between whites, blacks, and Hispanics with traumatic brain injury (TBI) at 1, 2, or 5 years after injury; to determine whether changes occur in postinjury employment rates over time for whites, blacks, and Hispanics; and to determine whether changes in postinjury employment rates over time are different for whites, blacks, and Hispanics. Setting Sixteen TBI Model System centers. Patients or Other Participants Persons (3,940) with moderate-to-severe TBI who self-reported as white, black, or Hispanic. Main Outcome Measurements Employment status dichotomized as competitively employed versus not competitively employed. Results The odds of competitive employment were significantly greater for whites versus blacks at 1, 2, and 5 years after injury and were greater for whites versus Hispanics at 1 and 2 years after injury; whites and Hispanics did not differ significantly at 5 years after injury; and blacks and Hispanics were not significantly different at 1, 2, or 5 years after injury. The odds of employment increased significantly from 1-2, 2-5, and 1-5 years after injury for whites and Hispanics, whereas the odds of employment increased from 2-5 and 1-5 years after injury for blacks, with no significant difference between 1 and 2 years after injury for blacks. No evidence was found that the changes in employment rates over time were significantly different among the race and/or ethnicity groups. Conclusion Future researchers should seek to identify causative factors for employment disparities, and rehabilitation professionals should work to mitigate inequalities in employment among racial and ethnic groups with TBI.