There are racial and ethnic differences in outcomes after SCI focused primarily on subjective outcomes in areas in which racial and ethnic minorities have traditionally been disadvantaged. The results of this study direct rehabilitation professionals to the outcomes that need to be targeted for intervention to eliminate inequities in outcomes for all persons with SCI.

We investigated relationships among personality, locus of control, and current postinjury employment status for 1,391 participants with spinal cord injury. Participants with higher internality locus-of-control scores and activity scores (personality) reported more favorable employment outcomes. Higher scores on chance and powerful others (locus of control), neuroticism, and aggression/hostility (personality) were associated with diminished employment outcomes.

Objective: The purpose of this study was to investigate heath disparities as a function of race and gender and the extent to which socioeconomic factors mediate disparities among participants with spinal cord injury.Design: Survey methodology. Cross-sectional data.Setting: A large Southeastern specialty hospital.Participants: There were 1,342 participants in the current analysis, all of whom were identified from patient records. There were 3 inclusion criteria: (a) traumatic SCI, (b) at least 18 years of age at the time of study, and (c) injury duration of more than 1 year.Main outcome measures: Six outcomes were measured, including 3 general outcomes (self-ratings, days impacted by poor health, days impacted by poor mental health) and 3 that reflect utilization of services (hospitalizations, days hospitalized, and nonroutine physician visits in the past 2 years). Results:Results of multivariate analysis of variance (MANOVA) indicated significant main effects for both race and gender. Follow-up tests identified racial disparities on 3 of the 6 outcomes, whereas gender disparities were observed for a single outcome. Years of education and household income mediated interrelationships between race and health (but not gender) as racial disparities disappeared after consideration of these factors.Conclusions: These findings suggest the need to work more diligently to promote better health outcomes among African Americans and to further investigate how socioeconomic factors and access to health care related to diminished health outcomes among African Americans with spinal cord injury.

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Study design: Longitudinal; Survey. Objective: The purpose of this study was to investigate the natural course of changes in activity patterns, health indicators, life satisfaction, and adjustment over 25-year period among people with spinal cord injury (SCI) in the USA. Setting: The preliminary data were collected from a Midwestern United States university hospital of the USA, whereas the follow-up data were collected at a large Southeastern United States rehabilitation hospital. Method: The Life Situation Questionnaire was used to identify changes in education/ employment, activities, medical treatments, adjustment, and life satisfaction. Results: Adjustment scores, satisfaction with employment, satisfaction with finances, years of education, and employment indicators significantly improved over time. In contrast, satisfaction with sex life, satisfaction with health, and then number of weekly visitors significantly decreased and the number of nonroutine medical visits and days hospitalized within 2 years prior to the study significantly increased over the 25-year period. Conclusion: Given the mixed pattern of favorable and unfavorable changes, the findings challenge the assumption that aging will inevitably be associated with the overall decline in outcomes and quality of life.