Race differences in diagnosis and surgery for occupational low back injuries

Area of Science:

• Occupational Health
• Health Services Research
• Health Disparities

Background:

• Documented disparities exist in workers' compensation outcomes between African Americans and whites with low back injuries.
• Race differences in diagnostic specificity and surgery rates may underlie these outcome disparities.

Purpose of the Study:

• To investigate the independent effect of race on diagnosis and surgery rates among workers' compensation claimants.
• To analyze how race influences diagnostic accuracy and surgical intervention for low back injuries.

Main Methods:

• A population-based telephone survey was conducted in Missouri.
• African American (n=580) and white (n=892) workers' compensation claimants with low back injuries were interviewed.
• Analyses controlled for clinical factors, legal representation, age, gender, and socioeconomic status to assess race's association with diagnosis (herniated disc vs. regional backache) and surgery.

Main Results:

• White claimants were 40% more likely to receive a herniated disc diagnosis compared to African American claimants.
• Among those diagnosed with a herniated disc, white claimants were 110% more likely to undergo surgery than African American claimants.

Conclusions:

• Race-based disparities in diagnosis and surgical rates were observed in workers' compensation claimants with low back injuries.
• These differences in diagnosis and treatment may contribute to the observed disparities in medical expenditures, disability ratings, and settlement awards.