Racial Differences in Employment Outcome After Traumatic Brain Injury at 1, 2, and 5 Years Postinjury
Abstract
Gary KW, Arango-Lasprilla JC, Ketchum JM, Kreutzer JS, Copolillo A, Novack TA, Jha A. Racial differences in employment outcome after traumatic brain injury at 1, 2, and 5 years postinjury.
Objectives
To examine racial differences in competitive employment outcomes at 1, 2, and 5 years after traumatic brain injury (TBI) and to determine whether changes in not competitive employment rates over time differ between blacks and whites with TBI after adjusting for demographic and injury characteristics.
Design
Retrospective cohort study.
Setting
Sixteen TBI Model System Centers.
Participants
Blacks (n=615) and whites (n=1407) with moderate to severe TBI.
Interventions
Not applicable.
Main Outcome Measure
Employment status dichotomized as competitively employed versus not competitively employed.
Results
After adjusting for demographic and injury characteristics, repeated-measures logistic regression indicated that (1) the odds of not being competitively employed were significantly greater for blacks than whites regardless of the follow-up year (all P<.001); (2) the odds of not being competitively employed declined significantly over time for each race (P≤.004); and (3) changes over time in the odds of not being competitively employed versus being competitively employed were not different between blacks and whites (P=.070). In addition, age, discharge FIM and Disability Rating Scale, length of stay in acute and rehabilitation, preinjury employment, sex, education, marital status, and cause of injury were significant predictors of employment status postinjury.
Conclusions
Short- and long-term employment is not favorable for people with TBI regardless of race; however, blacks fare worse in employment outcomes compared with whites. Rehabilitation professionals should work to improve return to work for all persons with TBI, with special emphasis on addressing specific needs of blacks.
aDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
bDepartment of Biostatistics, Virginia Commonwealth University, Richmond, VA
cDepartment of Occupational Therapy, Virginia Commonwealth University, Richmond, VA
dDepartments of Physical Medicine and Rehabilitation and Psychology, University of Alabama at Birmingham, Birmingham, AL
eDepartment of Physical Medicine and Rehabilitation, Craig Hospital, University of Colorado School of Medicine, Englewood, CO
Reprint requests to Kelli W. Gary, PhD, MPH, OTR/L, Dept of Physical Medicine and Rehabilitation, Virginia Commonwealth University, 730 E Broad St, PO Box 843038, Richmond, VA 23219
Supported by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education (grant nos. H133A070036, HI33P040006, H133A070039, H133A060038).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT