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Disparities in disability after traumatic brain injury among Hispanic children and adolescents
Nathalia Jimenez1, Beth E Ebel, Jin Wang
1Department of Anesthesiology and Pain Medicine, Seattle, WA 98105, USA. nathalia.jimenez@seattlechildrens.org
Insights
Hispanic children experience greater long-term disability after traumatic brain injury (TBI) compared to non-Hispanic white children. This study highlights significant disparities in quality of life and daily functioning post-TBI.
Area of Science:
- Pediatric neurology
- Public health
- Rehabilitation medicine
Background:
- Traumatic brain injury (TBI) is a significant cause of acquired disability in children.
- Ethnic disparities in healthcare access and outcomes are well-documented.
- Understanding long-term functional outcomes after pediatric TBI is crucial for effective intervention.
Purpose of the Study:
- To compare the long-term functional outcomes of mild, moderate, and severe traumatic brain injury (TBI) in Hispanic and non-Hispanic white (NHW) children.
- To identify ethnic differences in health-related quality of life, adaptive skills, and participation after pediatric TBI.
- To inform targeted interventions for improving TBI recovery in diverse pediatric populations.
Main Methods:
- Prospective cohort study of children under 18 years treated for TBI.
- Inclusion of Hispanic (n=74) and NHW (n=457) children.
- Assessment of disability in quality of life, adaptive skills, and participation at 3, 12, 24, and 36 months post-injury, adjusted for covariates.
Main Results:
- All children experienced reduced health-related quality of life post-TBI.
- Hispanic children showed persistent significant impairments in quality of life, communication, and self-care compared to NHW children.
- Differences in participation were significant only at 3 months post-injury.
Conclusions:
- Hispanic children with TBI face greater and more prolonged reductions in quality of life and functional abilities than NHW children.
- Significant disparities exist in communication, self-care, and overall participation post-TBI between these ethnic groups.
- Further research is needed to understand the underlying reasons for these disparities and to develop targeted interventions to improve outcomes for Hispanic children with TBI.
Objective:
To compare the extent of disability in multiple areas of functioning after mild, moderate, and severe traumatic brain injury (TBI) between Hispanic and non-Hispanic white (NHW) children.
Methods:
This was a prospective cohort study of children aged <18 years treated for a TBI between March 1, 2007, and September 30, 2008. Hispanic (n = 74) and NHW (n = 457) children were included in the study. Outcome measures were disability in health-related quality of life, adaptive skills, and participation in activities 3, 12, 24, and 36 months after injury compared with preinjury functioning. We compared change in outcome scores between Hispanic and NHW children at each follow-up time. All analyses were adjusted for age, gender, severity and intent of injury, insurance, family function at baseline, parental education, and income.
Results:
The health-related quality of life for all children was lower at all follow-up times compared with baseline. Although NHW children showed some improvement during the first 3 years after injury, Hispanic children remained significantly impaired. Significant differences were also observed in the domains of communication and self-care abilities after TBI. Differences between groups in scores for participation in activities were also present but were only significant 3 months after injury.
Conclusions:
Hispanic children with TBI report larger and long-term reductions in their quality of life, participation in activities, communication, and self-care abilities compared with NHW children. The reasons for these differences need to be better understood and interventions implemented to improve the outcomes of these children.
