title: Race and socioeconomic differences in post-settlement outcomes for African American and Caucasian Workers' Compensation claimants with low back injuries.
abstract: The purpose of this study was to predict post-settlement pain intensity, psychological distress, disability, and financial struggle among African American (n=580) and non-Hispanic Caucasian (n=892) Workers' Compensation claimants with single incident low back injury. The study was a population-based telephone survey conducted in three population centers in Missouri. Post-settlement outcomes were predicted from claimant demographics (race, age, gender); socioeconomic status (SES); diagnosis and legal representation; and Workers' Compensation resolution variables (treatment costs, temporary disability status, disability rating, settlement costs). Simultaneous-entry, hierarchical multiple linear regression analyses indicated that African American race and lower SES predicted higher levels of post-settlement pain intensity, psychological distress (general mental health, pain-related catastrophizing), disability (pain-related role interference), and financial struggle, independent of age, gender, diagnosis, legal representation, and Workers' Compensation resolution variables. The results suggest that African American race and lower SES-relative to Caucasian race and higher SES-are risk factors for poor outcomes after occupational low back injury. Mechanisms to explain these associations are discussed, including patient-level, provider-level, legal, and Workers' Compensation system-level factors.
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, Chapel Hill, NC, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Chibnall
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Tait
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 / Q000706:statistics & numerical data*; D003625:Data Collection; D004185:Disability Evaluation; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D017116:Low Back Pain / Q000191:economics* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D009784:Occupational Diseases / Q000191:economics / Q000453:epidemiology; D016272:Occupational Health / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D012307:Risk Factors; D012923:Social Class; D044465:White People / Q000706:statistics & numerical data*; D014942:Workers' Compensation / Q000706:statistics & numerical data*