Healthcare access after spinal cord injury and traumatic brain injury: A comparison with the general population
Rigor and Relevance of Disability Research Evidence
Our objective was to identify the extent to which African-Americans with spinal cord injury (SCI) or traumatic brain injury (TBI) have equal health care access (HCA) compared to African-Americans in the general population.
African-American adults with TBI (n=182) and SCI (n=178) from South Carolina participated in a mail-in survey. Questions were selected from the Behavioral Risk Factor Surveillance System (BRFSS) so comparisons could be made with the African-American general population in the state. General population estimates for African-Americans in South Carolina were pulled from the BRFSS conducted by the Centers for Disease Control and Prevention. Descriptive statistics were generated comparing health care access between those with SCI, TBI, and the general population.
African-Americans with TBI were less likely to have any kind of health care coverage than African-Americans in the general population (60.9% vs. 76.1%), and were less likely to have one person they thought of as their personal doctor (44.8% vs. 73.4%). Additionally, they were much more likely to have had a time in the past 12 months where they could not see a doctor because of costs (37.6% vs. 21.0%). African-Americans with TBI were less likely to have had a routine check-up in the past year (63.7% vs. 74.7%). Persons with SCI were not as different from the general population in terms of health care coverage. However, they were less likely to have one person they thought of as their personal doctor (53.5% vs. 73.4%), and were more likely to have been 5 or more years or never without having a routine check-up (10.7% vs. 4.2%).It is clear that African-Americans with neurologic injury (SCI or TBI) have less access to care than African-Americans in the general population. Persons with a disability are a vulnerable population, and this reduced access to health care could create even wider disparities in health outcomes.