Disparities in subjective well-being, participation, and health after spinal cord injury: a 6-year longitudinal study.
OBJECTIVE
To identify disparities and changes in subjective well-being, participation, and health over a 6-year period as a function of race-ethnicity and gender in persons with spinal cord injury (SCI).


METHODS
Stratified sampling was used to maximize inclusion of women and racial-ethnic minorities. Three model SCI systems participated, representing the Southeastern, Western, and Mountain regions of the United States. 250 participants completed measures on two occasions. Similar portions of Caucasians (n = 62), African-Americans (n = 61), American-Indians (n = 56), and Hispanics (n = 71) participated. Women made up approximately 43.1% of the sample. Three sets of outcome measures assessed: (a) subjective well-being and depressive symptoms, (b) participation, and (c) health.


RESULTS
MANOVA indicated significant effects for race-ethnicity (between subjects effect) and time (within subjects effect) but not for gender or the interaction effects. A Bonferroni correction was used to compare outcomes as a function of race-ethnicity and time. Five outcomes were significantly related to race-ethnicity, whereas no items were significantly related to the time effect after the Bonferroni correction. Caucasians reported best subjective well-being scores in several domains followed by African-Americans. Caucasians also reported more hours out of bed than either African-Americans or Hispanics.


CONCLUSIONS
Over a 6-year period, race-ethnicity continued to be related to differences in subjective well-being and participation but not health. Disparities in outcomes did not systematically increase or diminish over time, suggesting that once developed, such disparities are unlikely to change in the absence of intervention.
Krause
James S
JS
College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA. krause@musc.edu
Saladin
Lisa K
LK
Adkins
Rodney H
RH
D001741:Black or African American / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000208:ethnology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data