The Influence of Minority Status on Job Stability After Traumatic Brain Injury
Received 22 March 2008; accepted 9 July 2008. published online 12 December 2008.
Objective
To determine the influence of minority status on job stability after traumatic brain injury (TBI).
Setting
TBI Model Systems Centers.
Participants
633 individuals (414 Caucasians vs. 219 Minorities) with primarily moderate to severe TBI hospitalized at one of the TBI Model Systems Centers between 1988 and 2001 with 3 years of continuous follow up employment data after discharge.
Main Outcome Measures
Job stability was defined as “stable” (competitively employed at all three follow-up visits), “unemployed” (not competitively employed at all three visits), and “unstable” (any other mixture of competitively employed and not competitively employed over the three follow-up visits).
Methods
A multinomial logistic regression model was used to model the effect of ethnicity on job stability post TBI after adjusting for injury and demographic characteristics.
Results
Compared to Caucasians, the adjusted odds for minorities were 3.587 times greater for being unemployed versus being stably employed (95% CI = 1.930, 6.668), 1.911 times greater for being unstably employed versus being stably employed (95% CI = 1.006, 3.628), and 1.878 times more greater for being unemployed versus being unstably employed (95% CI = 1.157, 3.046) after adjusting for preinjury employment status, age, marital status, education, cause of injury, total length of stay in acute and rehabilitation hospitals, and DRS at discharge.
Conclusions
Minority status is an independent predictor of short-term job stability after TBI. Minority TBI survivors were more likely than Caucasians to be unemployed or unstably employed. Rehabilitation professionals should develop employment interventions that will address the specific needs of these racial/ethnic groups and facilitate optimal employment outcomes for minority TBI survivors.
aDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University Rehabilitation Psychology and Neuropsychology, VCU West Hospital, 3rd Floor Room 3-102, 1200 East Broad St., Richmond, VA 23298⁎
bDepartment of Biostatistics, Virginia Commonwealth University, Richmond, VA⁎
cDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA⁎
dDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA⁎
eDepartment of Physical Medicine and Rehabilitaton, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, and the Department of Speech-Language Pathology and Audiology, Northeastern University, Boston, MA⁎
fDepartment of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA⁎
gDepartment of Neurology, University of Texas Southwestern Medical Center, Dallas, TX⁎
hDepartment of Physical Medicine and Rehabilitation, Craig Hospital, University of Colorado School of Medicine, Englewood, CO⁎
Address correspondence to: J.C.A.-L.
Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org
This research was supported by grants H133A070036 and H133P040006 from the National Institute on Disability and Rehabilitation Research, United States Department of Education.
ABSTRACT