TY - JOUR
T1 - Race and socioeconomic differences in post-settlement outcomes for African American and Caucasian Workers' Compensation claimants with low back injuries
AU - Chibnall, John T.
AU - Tait, Raymond C.
AU - Andresen, Elena M.
AU - Hadler, Nortin M.
N1 - Funding Information:
Supported by a grant (R01 HS013087-01) from the Agency for Healthcare Research and Quality (AHRQ). The authors are indebted to Richard Stickann and Lawrence D. Leip of the Missouri Division of Workers' Compensation for their invaluable assistance with this project.
PY - 2005/4
Y1 - 2005/4
N2 - The purpose of this study was to predict post-settlement pain intensity, psychological distress, disability, and financial struggle among African American (n=580) and non-Hispanic Caucasian (n=892) Workers' Compensation claimants with single incident low back injury. The study was a population-based telephone survey conducted in three population centers in Missouri. Post-settlement outcomes were predicted from claimant demographics (race, age, gender); socioeconomic status (SES); diagnosis and legal representation; and Workers' Compensation resolution variables (treatment costs, temporary disability status, disability rating, settlement costs). Simultaneous-entry, hierarchical multiple linear regression analyses indicated that African American race and lower SES predicted higher levels of post-settlement pain intensity, psychological distress (general mental health, pain-related catastrophizing), disability (pain-related role interference), and financial struggle, independent of age, gender, diagnosis, legal representation, and Workers' Compensation resolution variables. The results suggest that African American race and lower SES - relative to Caucasian race and higher SES - are risk factors for poor outcomes after occupational low back injury. Mechanisms to explain these associations are discussed, including patient-level, provider-level, legal, and Workers' Compensation system-level factors.
AB - The purpose of this study was to predict post-settlement pain intensity, psychological distress, disability, and financial struggle among African American (n=580) and non-Hispanic Caucasian (n=892) Workers' Compensation claimants with single incident low back injury. The study was a population-based telephone survey conducted in three population centers in Missouri. Post-settlement outcomes were predicted from claimant demographics (race, age, gender); socioeconomic status (SES); diagnosis and legal representation; and Workers' Compensation resolution variables (treatment costs, temporary disability status, disability rating, settlement costs). Simultaneous-entry, hierarchical multiple linear regression analyses indicated that African American race and lower SES predicted higher levels of post-settlement pain intensity, psychological distress (general mental health, pain-related catastrophizing), disability (pain-related role interference), and financial struggle, independent of age, gender, diagnosis, legal representation, and Workers' Compensation resolution variables. The results suggest that African American race and lower SES - relative to Caucasian race and higher SES - are risk factors for poor outcomes after occupational low back injury. Mechanisms to explain these associations are discussed, including patient-level, provider-level, legal, and Workers' Compensation system-level factors.
KW - Back injuries
KW - Disability evaluation
KW - Employment
KW - Health services research
KW - Healthcare disparities
KW - Race
KW - Socioeconomic factors
KW - Treatment outcomes
KW - Workers' compensation
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U2 - 10.1016/j.pain.2005.01.011
DO - 10.1016/j.pain.2005.01.011
M3 - Article
C2 - 15777871
AN - SCOPUS:15244341531
SN - 0304-3959
VL - 114
SP - 462
EP - 472
JO - Pain
JF - Pain
IS - 3
ER -