Do racial/ethnic differences exist in post-injury outcomes after TBI? A comprehensive review of the literature.
OBJECTIVE
(1) To describe demographic and injury characteristics that are prominent among African Americans and Hispanics with TBI; (2) To determine if racial differences exist in regard to post-injury outcomes; (3) To highlight potential causes of racial/ethnic disparities in TBI rehabilitation and post-acute services; (4) To suggest recommendations to equalize outcomes; and stimulate future TBI research.


METHODS
Using MEDLINE, PyschINFO, CINAHL and InfoTrac databases, 39 peer-reviewed journal articles were found that met the following inclusion criteria: research studies that reported data for African Americans and Hispanics with TBI, outcomes from both primary and secondary analyses including paediatric patients with TBI and caregivers.


RESULTS
African Americans and Hispanics have worse functional outcomes and community integration and are less likely to receive treatment and be employed than Whites post-TBI. Emerging research detects racial and ethnic differences in marital stability, emotional/neurobehavioural complications and QOL outcomes; however, more research is needed to corroborate significant findings. African American and Hispanic caregivers express more burden, spend more time in caregiving role, have fewer needs met and use different types of coping strategies than White counterparts.


CONCLUSIONS
The racial and ethnic differences noted in this literature review are an indicator that minorities are at disproportionate risk for poorer outcomes. Post-acute interventions should specifically target minorities to diminish inequities that exist.
Gary
Kelli Williams
KW
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23219, USA. williamsjonk@vcu.edu
Arango-Lasprilla
Juan Carlos
JC
Stevens
Lillian Flores
LF
D001741:Black or African American / Q000208:ethnology*; D001930:Brain Injuries / Q000453:epidemiology / Q000208:ethnology / Q000534:rehabilitation*; D003431:Cross-Cultural Comparison; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function; D012944:Social Support; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D044465:White People / Q000208:ethnology*