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

Abstract

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.

Health-Related Quality of Life in Children and Adolescents Following Traumatic Injury: A Review

“…First, ethnicity has not been a focus of most studies; however, recent research with adults suggests poorer life satisfaction and well-being in ethnic minority adults following specific traumatic injury (Arango-Lasprilla et al 2009; Krause et al 2009). Further investigation of HRQOL outcomes across racial and ethnic groups seems prudent, particularly when considered in conjunction with other factors such as SES.…”

Ethnicity and rehabilitation outcomes: the Needs Assessment Checklist

“…10,12 Previous studies also indicate significant differences on account of ethnicity within psychological rehabilitation outcomes, with BME individuals found to score lower when examining 'satisfaction with life' and subjective well-being. 14,15 When examining NAC2, significant differences were again evident within the psychological well-being and physical healthcare domains between White and Black individuals. In addition to this, White individuals were also shown to demonstrate better rehabilitation outcomes within the domain of community preparation.…”

An examination of Māori tamariki (child) and taiohi (adolescent) traumatic brain injury within a global cultural context

“…The international literature identified in this search describes high rates of TBI in minority and indigenous cultures as well as disparities in the way in which services respond to people with TBI. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] One study found that 'black' children with TBI had significant pre-morbidities, penetrating trauma, injuries characterised by violent intent, higher unadjusted mortality and longer mean intensive care stays. These children were more likely to be discharged to an inpatient rehabilitation facility and had increased risk of functional deficit on discharge for the domains studied.…”

“…A number of studies have demonstrated that ethnic cultural factors are associated with different outcomes at all stages of the TBI journey in non-indigenous populations. [26][27][28][29][30][31][32][33][34][35][36][37] TBI caused by violence has been shown to be higher in adult minority groups. 27 Differences have also been shown in initial management of TBI and in referral to post-emergency department hospital care.…”

“…27 Despite non-Hispanics having higher functional status, Hispanics had higher rates of discharge home after adjusting for demographic factors, health-related factors and functional status at the time of discharge. 33 Arango-Lasprilla measured life satisfaction in a retrospective study of 3368 people, 1 year after moderate to severe TBI, 34 and found that African Americans had a lower life satisfaction than other groups.…”