title: Management of occupational back injuries: differences among African Americans and Caucasians.
abstract: This study examined differences in the case management of occupational low back injuries in a large, racially diverse population of Workers' Compensation claimants in Missouri. Participants were African Americans (N=580) and non-Hispanic whites (N=892) who had filed occupational injury claims that were settled over an 18-month period. Telephone interview data were gathered regarding diagnoses, legal representation, demographics, and socioeconomic status. The Missouri Division of Workers' Compensation also provided information on medical and temporary disability expenditures, claim duration, final disability ratings, and settlement awards. Simultaneous-entry, hierarchical multiple and logistic regression analyses showed significant and substantial effects for injury-related variables, socioeconomic status, and race across all Workers' Compensation variables. Differences remained for both injury and African Americans and lower socioeconomic status workers after controlling for injury, and for African Americans after controlling for both injury and socioeconomic status. Because Workers' Compensation mandates equal access to treatment and disability reimbursement for all injured workers, the differences observed in this study may reflect sociocultural biases in disability management among healthcare providers.
authors.affiliation: Department of Psychiatry, Saint Louis University School of Medicine, 1221 S. Grand Blvd., St. Louis, MO 63104, USA School of Public Health, Saint Louis University, St. Louis, MO, USA Departments of Medicine and Microbiology/Immunology, School of Medicine, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Tait
authors.forename: John T
authors.initials: JT
authors.lastname: Chibnall
authors.forename: Elena M
authors.initials: EM
authors.lastname: Andresen
authors.forename: Nortin M
authors.initials: NM
authors.lastname: Hadler
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D019567:Back Injuries / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012959:Socioeconomic Factors; D044465:White People; D014942:Workers' Compensation / Q000706:statistics & numerical data