Racial differences in employment outcomes after traumatic brain injury

Objective: To examine racial differences in employment status and occupational status I year after a traumatic brain injury (TBI). Design: Retrospective study. Setting: Longitudinal dataset of the Traumatic Brain Injury Model Systems national database. Participants: Subjects with primarily moderate to severe TBI (3468 whites vs 1791 minorities) hospitalized between 1989 and 2005. Interventions: Not applicable. Main Outcome Measures: Employment status (competitively employed or unemployed) and occupational status (professional/managerial, skilled, or manual labor) at 1 year postinjury. Results: Race and/or ethnicity has a significant effect on employment status at 1 year postinjury (chi(2)(1) = 58.23, P <.001), after adjusting for preinjury employment status, sex, Disability Rating Scale at discharge, marital status, cause of injury, age, and education. The adjusted odds of being unemployed versus competitively employed are 2.17 times (95% confidence interval, 1.78-2.65) greater for minorities than for whites. Race and ethnicity does not have a significant effect on occupational status at I year postinjury. Conclusions: With this empirical evidence supporting racial differences in employment outcomes between minorities and whites at I year postinjury, priority should be given to tailoring interventions to maximize minority survivors' work-related productivity.