Relationship of race/ethnicity and income to community integration following traumatic brain injury: Investigation in a non-rehabilitation trauma sample

Issue title: The role of race/ethnicity on outcomes after central nervous system injury

Guest editors: Juan Carlos Arango-Lasprilla

Article type: Research Article

Authors: Sander, Angelle M.^{a; b; c; *} | Pappadis, Monique R.^{c; d} | Davis, Lynne Cole^{a; c} | Clark, Allison N.^{a; c} | Evans, Gina^{a; e} | Struchen, Margaret A.^{a; c} | Mazzei, Diana M.^c

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA | [b] Center for Trauma Rehabilitation Research, Harris County Hospital District, Houston, TX, USA | [c] Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA | [d] Department of Health and Human Performance, University of Houston, Houston, TX, USA | [e] Chronic Disease Prevention and Control Center, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

Correspondence: [*] Address for correspondence: Angelle M. Sander, Ph.D., Brain Injury Research Center, 2323 South Shepherd Drive, Ste. 907, Houston, TX 77019, USA. Tel.: +1 713 630 0515; Fax: +1 713 630 0529; E-mail: asander@bcm.edu

Abstract: The purpose of the current study was to determine the contribution of race/ethnicity and income to community integration at approximately 6 months following traumatic brain injury (TBI). Participants were 151 persons with mild to severe TBI (38% Black; 38% Hispanic; 24% White) recruited from consecutive admissions to the Neurosurgery service of a county Level I trauma center. A large number of participants had low income and low education. Community integration was assessed using the Community Integration Questionnaire (CIQ), Craig Handicap Assessment and Reporting Technique – Short Form (CHART-SF), and Community Integration Measure (CIM). Results of analysis of covariance (ANCOVA) indicated that, after accounting for injury severity, age, education, and income, race/ethnicity contributed significantly to the variance in CIQ Total score, Home Integration Scale, and Productive Activity Scale scores. Blacks had lower CIQ Total scores compared to Whites. Black and Hispanic participants had lower scores than Whites on the Home Integration Scale, and Blacks had lower scores than Whites and Hispanics on the CIQ Productive Activity Scale. Low income (⩽ $20,000) was related to lower scores on the CIQ and CHART-SF Social Integration Scales, and scores on the CIM Total, Belonging, and Independent Participation scales. These results indicate that racial/ethnic differences in community integration exist, even after accounting for income. However, income was more predictive than race/ethnicity for certain aspects of community integration, indicating that it should be accounted for in all studies investigating racial/ethnic differences in outcomes.

Keywords: Traumatic brain injury, race/ethnicity, income, community integration

DOI: 10.3233/NRE-2009-0450

Journal: NeuroRehabilitation, vol. 24, no. 1, pp. 15-27, 2009