Racial and Ethnic Disparities in Employment Outcomes for Persons With Traumatic Brain Injury: A Longitudinal Investigation 1-5 Years After Injury

ObjectiveTo determine whether differences exist in employment rates between whites, blacks, and Hispanics with traumatic brain injury (TBI) at 1, 2, or 5 years after injury; to determine whether changes occur in postinjury employment rates over time for whites, blacks, and Hispanics; and to determine whether changes in postinjury employment rates over time are different for whites, blacks, and Hispanics.SettingSixteen TBI Model System centers.Patients or Other ParticipantsPersons (3,940) with moderate-to-severe TBI who self-reported as white, black, or Hispanic.Main Outcome MeasurementsEmployment status dichotomized as competitively employed versus not competitively employed.ResultsThe odds of competitive employment were significantly greater for whites versus blacks at 1, 2, and 5 years after injury and were greater for whites versus Hispanics at 1 and 2 years after injury; whites and Hispanics did not differ significantly at 5 years after injury; and blacks and Hispanics were not significantly different at 1, 2, or 5 years after injury. The odds of employment increased significantly from 1-2, 2-5, and 1-5 years after injury for whites and Hispanics, whereas the odds of employment increased from 2-5 and 1-5 years after injury for blacks, with no significant difference between 1 and 2 years after injury for blacks. No evidence was found that the changes in employment rates over time were significantly different among the race and/or ethnicity groups.ConclusionFuture researchers should seek to identify causative factors for employment disparities, and rehabilitation professionals should work to mitigate inequalities in employment among racial and ethnic groups with TBI.