Abstract Details

Previous studies have identified a relationship between TBI and sociodemographic variables, such as race and insurance status. However, few studies have investigated these variables in a minority-majority population in the United States.

Investigate potential sociodemographic disparities and medical comorbidities associated with the diagnosis and management of traumatic brain injury (TBI) in a minority-majority state.

A retrospective case-control study was conducted on TBI patients seen at a traumatic brain injury center within the last 2 years. We identified 412 patients with TBI. 412 unmatched controls were randomly selected from the institution’s patient pool. Injury characteristics, sociodemographic information, and psychological and biological variables were collected.

Patients diagnosed with TBI had higher odds of being younger (p<0.0001), male (p<0.0001), Native Hawaiian or other Pacific Islander (NHPI; p=0.049), and having a lower median household income (p=0.032). NHPI patients with TBI were 2.87 times more likely to have Medicaid insurance (95% CI: 1.70-4.85; p<0.0001). Asian patients with TBI were 6.36 times (95% CI: 3.22-13.17; p<0.0001) less likely to have depression at diagnosis compared to other races. In contrast, other underrepresented minorities (OUM) reported depression 6.62 times more (95% CI: 1.18-16.89; p=0.022). Hispanics reported sleep disturbance 18.23 times more (95% CI: 1.76-909.14; p=0.0049). Caucasian patients with TBI underwent diagnostic imaging 1.99 times more than other races (95% CI: 1.23-3.23; p=0.0042). 

Patients with TBI were more likely to be young, male, NHPI, and have a lower median income, which suggests a potential socioeconomic disparity. In addition, differing rates of Medicaid insurance, sleep disturbances, depression, and diagnostic imaging amongst ethnoracial groups indicates the need for a biopsychosocial approach to TBI management.