Research Reports - Unemployment in the United States after traumatic brain injury for working-age individuals

J Head Trauma Rehabil. 2015 May-Jun;30(3):160-74

Cuthbert JP(1), Harrison-Felix C, Corrigan JD, Bell JM, Haarbauer-Krupa JK,
Miller AC

OBJECTIVE: To estimate the prevalence of unemployment and part-time employment in
the United States for working-age individuals completing rehabilitation for a
primary diagnosis of traumatic brain injury (TBI) between 2001 and 2010.
DESIGN: Secondary data analysis.
SETTING: Acute inpatient rehabilitation facilities.
PARTICIPANTS: Patients aged 16 to 60 years at injury who completed inpatient
rehabilitation for TBI between 2001 and 2010.
MAIN OUTCOME MEASURES: Unemployment; Part-time employment.
RESULTS: The prevalence of unemployment for persons in the selected cohort was
60.4% at 2-year postinjury. Prevalence of unemployment at 2-year postinjury was
significantly associated with the majority of categories of age group, race,
gender, marital status, primary inpatient rehabilitation payment source,
education, preinjury vocational status, length of stay, and Disability Rating
Scale. The direction of association for the majority of these variables
complement previous research in this area, with only Hispanic ethnicity and the
FIM Cognitive subscale demonstrating disparate findings. For those employed at
2-year postinjury, the prevalence of part-time employment was 35.0%. The model of
prevalence for part-time employment at 2-year postinjury was less robust, with
significant relationships with some categorical components of age group, gender,
marital status, primary payment source, preinjury vocational status, and
Disability Rating Scale.
CONCLUSIONS: The prevalence of unemployment for patients completing inpatient
rehabilitation for TBI was substantial (60.4%). The majority of factors found to
associate with 2 years' unemployment were complementary of previously published
research; however, these were often smaller in magnitude than previous reports.
The prevalence of part-time employment was also an issue for this cohort and
included 35.0% of all employed individuals. In regard to the determination of
factors associated with part-time employment, additional analyses that include
more fine-grained factors associated with employment, including physical and
psychosocial functioning, are recommended.

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