Injury and demographic factors predictive of disparities in earnings after spinal cord injury

Objective: To identify differences in earnings after spinal cord injury (SCI) attributable to demographic factors, injury severity, and education using a regression model that accounts for employment status, conditional earnings (earnings of those employed only), and unconditional earnings (earnings from employment for all participants with $0 recorded for those unemployed). Design: Secondary analysis of cross-sectional survey data. Setting: A midwestern university hospital and a private hospital in the southeastern United States. Participants: Adults with traumatic SCI of at least 2 years duration and under the traditional retirement age of 65 completed mailed surveys (n=615). Interventions: Not applicable. Main Outcome Measures: Conditional and unconditional earnings. Earnings were measured by a single item that grouped earnings into the following 8 categories: (1) less than $10,000, (2) $10,000 to $14,999, (3) $15,000 to 19,999, (4) $20,000 to 24,999, (5) $25,000 to 34,999, (6) $35,000 to 49,999, (7) $50,000 to 74,999, and (8) $75,000 or more. Results: Several factors investigated were significantly associated with employment status (sex, race, age, neurologic level of injury, ambulatory status, years since injury, educational level), but conditional earnings were significantly related to only 3 factors. Higher conditional earnings were obtained by men, non-African Americans, and those with a college degree. Unconditional earnings were significantly higher among those with the following characteristics: male, non-African Americans, age 34 and less, ambulatory, and those who completed some education beyond high school. Conclusions: There are substantial differences in the likelihood of postinjury employment as a function of participant characteristics. These disparities are compounded for women, African Americans, and those with less than a college degree by differences in conditional earnings among those employed.