Race and ethnicity considerations in traumatic brain injury research: Incidence, reporting, and outcome

ABSTRACT Primary Objective This study has three goals: to determine whether there is a higher rate of traumatic brain injury (TBI) for people of color (POC), whether TBI studies report racial/ethnic demographics, and whether there is a discrepancy in discharge destinations between Whites and POC. We examined whether 1) a higher percentage of POC would sustain head injuries than expected, 2) the majority of TBI studies examined (>50%) would not include racial/ethnic demographics, and 3) Whites would be discharged to further treatment over POC. Research Design Retrospective study and literature review. Methods and Procedures Data from the Pennsylvania Trauma System Foundation was used to determine the number of POC with TBI using X 2 analysis, as well as where patients with TBI were being discharged using a configural frequency analysis. PubMed was used for the literature search to examine the frequency of reporting race/ethnicity in TBI literature. Main Outcomes and Results Results demonstrated that Blacks sustain more TBIs than would be expected (p < .05), the majority of scientific studies (78%) do not report racial/ethnic demographic information, and Whites are discharged to further care more often than POC. Conclusions These findings highlight differences in incidence and treatment of TBI between White individuals and POC, raising important considerations for providers and researchers.

[1]  R. Cooper,et al.  Race, Ancestry, and Reporting in Medical Journals. , 2018, JAMA.

[2]  A. Tyroch,et al.  Ethnic disparities in traumatic brain injury care referral in a Hispanic-majority population. , 2017, The Journal of surgical research.

[3]  Tanisha D Belton,et al.  A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. , 2017, Social science & medicine.

[4]  F. Hillary,et al.  Trends in alcohol use during moderate and severe traumatic brain injury: 18 years of neurotrauma in Pennsylvania , 2016, Brain injury.

[5]  K. McBrien,et al.  What is the scope of improving immigrant and ethnic minority healthcare using community navigators: A systematic scoping review , 2016, International Journal for Equity in Health.

[6]  A. Charles,et al.  Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury. , 2015, Journal of neurosurgery.

[7]  M. Stemmler.  Person-Centered Methods: Configural Frequency Analysis (Cfa) and Other Methods for the Analysis of Contingency Tables , 2014 .

[8]  L. Chan,et al.  Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain. , 2014, Archives of physical medicine and rehabilitation.

[9]  E. Schneider,et al.  Race and insurance disparities in discharge to rehabilitation for patients with traumatic brain injury. , 2013, Journal of neurotrauma.

[10]  M. Koenig,et al.  Favorable outcomes for Native Hawaiians and other Pacific Islanders with severe traumatic brain injury. , 2013, Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health.

[11]  Yawen Hsu,et al.  Injured athletes' rehabilitation beliefs and subjective well-being: the contribution of hope and social support. , 2013, Journal of athletic training.

[12]  J. Powell,et al.  Neurobehavioural symptoms 1 year after traumatic brain injury: A preliminary study of the relationship between race/ethnicity and symptoms , 2012, Brain injury.

[13]  E. Haut,et al.  Racial, ethnic, and insurance status disparities in use of posthospitalization care after trauma. , 2011, Journal of the American College of Surgeons.

[14]  Scott R. Laker.  Epidemiology of Concussion and Mild Traumatic Brain Injury , 2011, PM & R : the journal of injury, function, and rehabilitation.

[15]  Eric J. Ley,et al.  Race affects mortality after moderate to severe traumatic brain injury. , 2010, The Journal of surgical research.

[16]  Eric J. Ley,et al.  Does Health Care Insurance Affect Outcomes after Traumatic Brain Injury? Analysis of the National Trauma Databank , 2010, The American surgeon.

[17]  T. Lum,et al.  Health Disparities Among Immigrant and Non-immigrant Elders: The Association of Acculturation and Education , 2010, Journal of Immigrant and Minority Health.

[18]  S. Levinson,et al.  WEIRD languages have misled us, too , 2010, Behavioral and Brain Sciences.

[19]  A. Norenzayan,et al.  The weirdest people in the world? , 2010, Behavioral and Brain Sciences.

[20]  R. M. Suinn.  Reviewing acculturation and Asian Americans: How acculturation affects health, adjustment, school achievement, and counseling. , 2010 .

[21]  G. Manley,et al.  Race\ethnicity and outcome after traumatic brain injury at a single, diverse center. , 2009, The Journal of trauma.

[22]  C. Nordstrom,et al.  Trust, mistrust, racial identity and patient satisfaction in urban African American primary care patients of nurse practitioners. , 2009, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[23]  J. Arango-Lasprilla,et al.  Do racial/ethnic differences exist in post-injury outcomes after TBI? A comprehensive review of the literature , 2009, Brain injury.

[24]  W. Darity,et al.  Latino racial choices: the effects of skin colour and discrimination on Latinos’ and Latinas’ racial self-identifications , 2008 .

[25]  K. Staudenmayer,et al.  Ethnic disparities in long-term functional outcomes after traumatic brain injury. , 2007, The Journal of trauma.

[26]  Diane P. Martin,et al.  Racial Disparities in Outcomes of Persons With Moderate to Severe Traumatic Brain Injury , 2007, Medical care.

[27]  J. Arango-Lasprilla,et al.  Cultural Issues in the Rehabilitation of TBI Survivors: Recent Research and New Frontiers , 2007 .

[28]  H. Thompson,et al.  Traumatic Brain Injury in Older Adults: Epidemiology, Outcomes, and Future Implications , 2006, Journal of the American Geriatrics Society.

[29]  Nallely Galván,et al.  Race and Ethnicity in Empirical Counseling and Counseling Psychology Research , 2005 .

[30]  J. Langlois,et al.  The Incidence of Traumatic Brain Injury Among Children in the United States: Differences by Race , 2005, The Journal of head trauma rehabilitation.

[31]  J. Bazarian,et al.  Mild traumatic brain injury in the United States, 1998–2000 , 2005, Brain injury.

[32]  Henry E. Wang,et al.  Out-of-hospital endotracheal intubation and outcome after traumatic brain injury. , 2004, Annals of emergency medicine.

[33]  G. Raque,et al.  Outcome following moderate traumatic brain injury. , 2003, Surgical neurology.

[34]  W. Hauser,et al.  The Epidemiology of Traumatic Brain Injury: A Review , 2003, Epilepsia.

[35]  D. Potoka,et al.  Development of a novel method to predict disability after head trauma in children. , 2003, Journal of pediatric surgery.

[36]  Marcel Dijkers,et al.  Systematic bias in traumatic brain injury outcome studies because of loss to follow-up. , 2003, Archives of physical medicine and rehabilitation.

[37]  H B Weiss,et al.  Traumatic brain injuries evaluated in U.S. emergency departments, 1992-1994. , 2000, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[38]  P. Jahn,et al.  Foundation , 2000, The World of Dew and Other Stories.

[39]  Susan Koshy.  Category Crisis: South Asian Americans and Questions of Race and Ethnicity , 1998, Diaspora: A Journal of Transnational Studies.

[40]  J. T. Lott.  Asian Americans: From Racial Category to Multiple Identities , 1998 .

[41]  S. Graham.  "Most of the subjects were White and middle class": Trends in published research on African Americans in selected APA journals, 1970–1989. , 1992 .

[42]  J. Ponterotto.  Racial/ethnic minority research in the Journal of Counseling Psychology: A content analysis and methodological critique. , 1988 .

[43]  B. Jennett,et al.  Assessment of coma and impaired consciousness. A practical scale. , 1974, Lancet.

[44]  M. Stemmler.  Person-Centered Methods , 2020, SpringerBriefs in Statistics.

[45]  D. Sleet,et al.  Using the public health model to address unintentional injuries and TBI: A perspective from the Centers for Disease Control and Prevention (CDC). , 2016, NeuroRehabilitation.

[46]  Stephen Pack.  Social support in sport injury rehabilitation. , 2013 .

[47]  J. DeLuca,et al.  Functional outcomes from inpatient rehabilitation after traumatic brain injury: how do Hispanics fare? , 2007, Archives of physical medicine and rehabilitation.

[48]  M. Farmer,et al.  Are racial disparities in health conditional on socioeconomic status? , 2005, Social science & medicine.

[49]  B. Smedley,et al.  Race as biology is fiction, racism as a social problem is real: Anthropological and historical perspectives on the social construction of race. , 2005, The American psychologist.

[50]  Jorge Duany.  Neither White nor Black: The Representation of Racial Identity Among Puerto Ricans on the Island and in the U.S. Mainland , 2005 .

[51]  I. H. López.  Race on the 2010 census: Hispanics & the shrinking white majority , 2005, Daedalus.

[52]  Michelle Putnam,et al.  Health and Wellness: People with Disabilities Discuss Barriers and Facilitators to Well Being. (Barriers and Facilitators to Well Being) , 2003 .

[53]  R. Puddy,et al.  Reporting of demographics, methodology, and ethical procedures in journals in pediatric and child psychology. , 2002, Journal of pediatric psychology.