Journal
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
Volume 90, Issue 10, Pages 1699-1707Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2009.04.014
Keywords
Brain injuries; Employment; Rehabilitation
Categories
Funding
- National Institute on Disability and Rehabilitation Research
- U.S. Department of Education [H133A070036, H133P040006, H133A070039, H133A060038]
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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.
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