Traumatic brain injury and functional outcomes: Does minority status matter?

Objectives: ( 1) to determine differences between minorities vs. non- minorities on demographic, injury and rehabilitation characteristics and functional outcomes at admission, discharge and 1- year post- injury and ( 2) to examine differences in functional outcome at 1- year post- injury among ( African- Americans, Hispanics and Whites). Design: Retrospective study. Setting: Longitudinal data were extracted from the TBI Model Systems database. Participants: 4929 individuals with moderate- to- severe TBI ( 3354 Whites vs. 1575 Minorities: 1207 African- Americans and 368 Hispanics) hospitalized between 1989 - 2004. Main outcome measures: Functional outcomes at 1- year post- injury ( Disability Rating Scale, Functional Independence Measure, Glasgow Outcome Scale- Extended and Community Integration Questionnaire). Results: At discharge and 1- year post- injury, minorities had poorer functional outcomes compared with Caucasians on all measures. After controlling for sociodemographic, injury and functional characteristics at admission, Hispanics and AfricanAmericans still showed worse functional outcomes at 1- year post- injury compared with Whites on the DRS, FIM and CIQ. There were no significant differences between African Americans and Hispanics. Conclusions: Minorities had significantly reduced long- term functional outcome after rehabilitation relative to Whites. It is imperative that rehabilitation professionals' consider factors related to poorer long- term functional outcome and work to improve the quality of life of minorities with TBI.