Effect of Race and Nativity on Functional Outcomes Following Traumatic Brain Injury Among Asian, Hispanic, and Non-Hispanic White Survivors in the United States: A NIDILRR TBI Model Systems Study.

Objective: To compare the racial/ethnic differences in traumatic brain injury (TBI) recovery among Asians, Hispanics, and Whites, and explore the effect of nativity in the recovery process.

Setting: Six Traumatic Brain Injury Model Systems (TBIMS) centers.

Participants: In total, 7953 patients who had at least 1 severe TBI between 2000 and 2016 were admitted to one of the TBIMS centers.

Design: Secondary data analysis.

Main Measures: Functional Independent Measure (FIM instrument) ratings.

Results: Asians had the lowest injury severity at admission, but they failed to make the improvements made by the Hispanics and the Whites between the rehabilitation discharge and the 1-year follow-up. The magnitude of improvement made by the foreign-born Asians was less than that made by their native-born counterparts. Both Asian and the Hispanic groups had lower functional outcomes at the 1-year follow-up, and the differences in functional outcomes between the Asian and Hispanic groups were not statistically significant. The above racial/ethnic disparities in functional outcomes were not fully explained by differences in sociodemographic status, injury characteristics, and immigration-related factors. The effect of nativity was mediated by covariates.

Conclusions: This study reveals racial/ethnic disparities post-TBI functional recovery. Despite lower injury severity and apparent financial resource advantages, Asians did not experience better functional outcomes. Although the effect of nativity was not established in this study, contextual factors related to ethnicity and immigration experiences should be further investigated.