Do racial/ethnic differences exist in post-injury outcomes after TBI? A comprehensive review of the literature

Primary objectives: (1) To describe demographic and injury characteristics that are prominent among African Americans and Hispanics with TBI; (2) To determine if racial differences exist in regard to post-injury outcomes; (3) To highlight potential causes of racial/ethnic disparities in TBI rehabilitation and post-acute services; (4) To suggest recommendations to equalize outcomes; and stimulate future TBI research. Methods and procedures: Using MEDLINE, PyschINFO, CINAHL and InfoTrac databases, 39 peer-reviewed journal articles were found that met the following inclusion criteria: research studies that reported data for African Americans and Hispanics with TBI, outcomes from both primary and secondary analyses including paediatric patients with TBI and caregivers. Main outcome and results: African Americans and Hispanics have worse functional outcomes and community integration and are less likely to receive treatment and be employed than Whites post-TBI. Emerging research detects racial and ethnic differences in marital stability, emotional/neurobehavioural complications and QOL outcomes; however, more research is needed to corroborate significant findings. African American and Hispanic caregivers express more burden, spend more time in caregiving role, have fewer needs met and use different types of coping strategies than White counterparts. Conclusion: The racial and ethnic differences noted in this literature review are an indicator that minorities are at disproportionate risk for poorer outcomes. Post-acute interventions should specifically target minorities to diminish inequities that exist.