Racial differences in employment outcome after traumatic brain injury at 1, 2, and 5 years postinjury.
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.


OBJECTIVE
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.


METHODS
Retrospective cohort study.


METHODS
Sixteen TBI Model System Centers.


METHODS
Blacks (n=615) and whites (n=1407) with moderate to severe TBI.


METHODS
Not applicable.


METHODS
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< or =.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.
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA. williamsjonk@vcu.edu
Kelli W
KW
Gary
Juan C
JC
Arango-Lasprilla
Jessica M
JM
Ketchum
Jeffrey S
JS
Kreutzer
Al
A
Copolillo
Thomas A
TA
Novack
Amitabh
A
Jha
D000328:Adult; D001741:Black or African American; D001930:Brain Injuries / Q000534:rehabilitation*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D044465:White People