TY - JOUR
T1 - Racial Differences in Employment Outcome After Traumatic Brain Injury at 1, 2, and 5 Years Postinjury
AU - Gary, Kelli W.
AU - Arango-Lasprilla, Juan C.
AU - Ketchum, Jessica M.
AU - Kreutzer, Jeffrey S.
AU - Copolillo, Al
AU - Novack, Thomas A.
AU - Jha, Amitabh
N1 - Funding Information:
Supported by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education (grant nos. H133A070036, HI33P040006, H133A070039, H133A060038).
PY - 2009/10
Y1 - 2009/10
N2 - 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. Objectives: 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. Design: Retrospective cohort study. Setting: Sixteen TBI Model System Centers. Participants: Blacks (n=615) and whites (n=1407) with moderate to severe TBI. Interventions: Not applicable. Main Outcome Measure: 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≤.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.
AB - 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. Objectives: 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. Design: Retrospective cohort study. Setting: Sixteen TBI Model System Centers. Participants: Blacks (n=615) and whites (n=1407) with moderate to severe TBI. Interventions: Not applicable. Main Outcome Measure: 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≤.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.
KW - Brain injuries
KW - Employment
KW - Rehabilitation
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U2 - 10.1016/j.apmr.2009.04.014
DO - 10.1016/j.apmr.2009.04.014
M3 - Article
C2 - 19801059
AN - SCOPUS:70350474527
SN - 0003-9993
VL - 90
SP - 1699
EP - 1707
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 10
ER -