The Influence of Minority Status on Job Stability After Traumatic Brain Injury

Objective: To determine the influence of minority status on job stability after traumatic brain injury (TBI). Setting: TBI Model Systems Centers. Participants: 633 individuals (414 Caucasians vs. 219 Minorities) with primarily moderate to severe TBI hospitalized at one of the TBI Model Systems Centers between 1988 and 2001 with 3 years of continuous follow up employment data after discharge. Main Outcome Measures: Job stability was defined as "stable" (competitively employed at all three follow-up visits), "unemployed" (not competitively employed at all three visits), and "unstable" (any other mixture of competitively employed and not competitively employed over the three follow-up visits). Methods: A multinomial logistic regression model was used to model the effect of ethnicity on job stability post TBI after adjusting for injury and demographic characteristics. Results: Compared to Caucasians, the adjusted odds for minorities were 3.587 times greater for being unemployed versus being stably employed (95% CI = 1.930, 6.668), 1.911 times greater for being unstably employed versus being stably employed (95% Cl = 1.006, 3.628), and 1.878 times more greater for being unemployed versus being unstably employed (95% Cl = 1.157, 3.046) after adjusting for preinjury employment status, age, marital status, education, cause of injury, total length of stay in acute and rehabilitation hospitals, and DRS at discharge. Conclusions: Minority status is an independent predictor of short-term job stability after TBI. Minority TBI survivors were more likely than Caucasians to be unemployed or unstably employed. Rehabilitation professionals should develop employment interventions that will address the specific needs of these racial/ethnic groups and facilitate optimal employment outcomes for minority TBI survivors.