Race/ethnicity differences in satisfaction with life among persons with traumatic brain injury

Objective: To determine differences in life satisfaction at 1-year post-TBI among Caucasian, African American, Hispanic, and Asian individuals with TBI, after adjusting for covariates that significantly differ between ethnic groups and/or affect the Satisfaction with Life Scale (SWLS) at one year post-injury. Design: Retrospective study. Setting: Longitudinal dataset of the TBI Model Systems National Database. Participants: 3,368 individuals with moderate to severe TBI (2478 Caucasian, 629 African American, 180 Hispanic, and 81 Asian/Pacific Islander) hospitalized between 1989 and 2005. Main Outcome Measures: Satisfaction with Life Total score at 1 year post injury. Results: African Americans had 3.21 units lower SWLS scores one year post-injury than Asian/Pacific Islanders (95% CI = 0.61-5.81) and 1.99 units lower SWLS scores than Caucasians (95% CI = 0.97-3.00) after controlling for marital status, employment at admission, cause of injury, FIM at discharge, and LOS in acute care. Conclusions: African Americans have poorer self-reported life satisfaction than Caucasians and Asians one year after TBI. This effect is not due to pre-injury marital or employment status, cause of injury, nor injury severity or functional status. Further research on the factors which might explain these differences is warranted, so that targeted rehabilitation programs can be designed and implemented that enhance quality of life for all individuals who have suffered a TBI.