Race and Factors Associated with Race: Influences on Productivity After Traumatic Brain Injury

Past Studies

Past Studies have shown that minorities and non-minorities have different risk factors, causes, death rates, and outcomes associated with traumatic brain injuries. African Americans appear to have a greater risk of experiencing a traumatic brain injury than other minority groups and non-minorities. Past research indicates that African Americans are more likely to sustain a violence-related traumatic brain injury and a traumatic brain injury that results in death. African Americans with traumatic brain injuries appear to experience similar recoveries as non-African Americans in rehabilitation. African Americans, however, have lesser rates of return to the level of lifestyle that they had in the community before injury, including a lesser rate of employment. Research is lacking about what other factors besides racial minority membership are associated with the different productive outcomes experienced by African Americans, members of other minority groups, and non-minorities after traumatic brain injury. “Productive outcomes” refers to the return of an individual to productive roles that are valued by society; such roles include student, employee, or homemaker.

This Study

This Study included 1,083 adults with traumatic brain injuries from all 17 of the Traumatic Brain Injury Model Systems. Participants were divided into groups according to race, as follows: White (633 participants), African American (323 participants), and Other Minority Group Members (127 participants). The researchers obtained information by examining the participant’s medical records and conducting in-person or phone surveys at one year after the individual’s injury date. Pre-injury and post-injury productivity was coded as productive if the individual was employed at least part-time, in school at least part-time, or a full-time homemaker. The researchers statistically analyzed the data to identify the degree to which race and other factors associated with race were associated with productive outcomes following traumatic brain injury.The researchers found a strong association when they examined race as the only predictive factor for productive outcomes. They found that 43% of whites, 22% of African Americans, and 28% of other minority group members were productive at one-year after their injuries. This meant that African Americans were 2.76 times more likely to be nonproductive than whites and that other minority group members were 1.92 times more likely to be nonproductive than whites. The researchers analyzed the data again without race included as a predictive factor for productive outcomes, but with other suspected factors. They found that pre-injury productivity, pre-injury educational levels, and the cause of the injury (violence related) were significantly linked to productive outcomes. Overall, they found that individuals who were productive at the time of their traumatic brain injury were 5.26 times more likely to be productive at one year after their injury date than individuals who were not productive at the time of their injury. The researchers also determined that the factors of pre-injury productivity, pre-injury educational levels, and the cause of the injury were not only associated with productive outcomes, but also with race as well. The researchers analyzed the data to determine the influence of both race and the outcome-related factors on productive outcomes. They found that African Americans were 2 times more likely to be nonproductive than whites and that other minority group members were 2.08 times more likely to be nonproductive than whites. This shows that the effect that race has on productive outcomes was influenced by the association of race with other pre injury contributing factors.

Who May Be Affected By These Findings

Individuals with traumatic brain injuries, researchers, health care providers, and prevention specialists

Caveats

The researchers found that the cause of injury was a factor that influenced productive outcomes. In this study, African Americans received more violence-related traumatic brain injuries. Based on the findings of other studies, the researchers suspect that a violence-related brain injury, in itself, may not be associated with negative productive outcomes. However, the factors associated with the cause of a violence-related traumatic brain injury might be. Such associated factors include lower levels of education, a poor work record, and a history of substance abuse. Future research is needed to include these variables, along with other considerations that may affect productivity outcomes. Other factors to be studied include access to services, transportation, and childcare, as well as rates of substance abuse and the economic climate.

Bottom Line

These findings demonstrate that the effect that race has on productive outcomes is significantly influenced by the association of race with other contributing factors such as pre-injury productivity, pre-injury educational levels, and cause of injury.

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