Disparities in Occupational Low Back Injuries: Predicting Pain-Related Disability from Satisfaction with Case Management in African Americans and Caucasians

Abstract

For African Americans and lower socioeconomic status persons in the Workers' Compensation system, less treatment/compensation was associated with lower satisfaction with the process, which in turn predicted higher levels of post-settlement disability. Given that the function of Workers' Compensation is to reduce disability from work-related injuries, the current results suggest that the system produces inequitable outcomes for these groups.

Clinical and Social Predictors of Application for Social Security Disability Insurance by Workers??? Compensation Claimants With Low Back Pain

“…The race finding is consistent with previous analyses of the DOLOR cohort, in which blacks, relative to whites, received lower ratings of residual disability at case settlement, were less likely to have a specific diagnosis or surgery, were less satisfied with their WC experience, and had poorer long-term outcomes with respect to pain, function, and psychologic state. [1][2][3][4] The satisfaction effects are consistent with other research that has documented increases in disability as a function of negative postinjury experiences with employers, healthcare providers, and case managers. 23,24,[37][38][39][40][41] Explanations for the race and satisfaction findings must of necessity be speculative.…”

“…4 Full details on the study methodology are provided elsewhere [2][3][4] and are only summarized here.…”

“…[1][2][3][4] Outcomes have included those specific to the WC system (eg, medical treatment expenditures, ratings of residual disability) and longer-term clinical outcomes specific to the claimant (eg, pain-related disability, pain catastrophizing, pain intensity, and psychologic distress). Another important outcome is application for Social Security Disability Insurance (SSDI) after closure of the WC claim, which we examine here.…”

Coping, Pain Severity, Interference, and Disability: The Potential Mediating and Moderating Roles of Race and Education

“…As in previous studies, 4,5,8,13,34,40,41 we found that African-American participants, on average, reported more pain, interference, and disability than their Caucasian counterparts. In addition, we found that African-American participants reported using diverting attention and prayer and hoping more than Caucasian participants.…”

“…[4][5][6]12,30,32 In addition, there are race differences in clinical and experimental pain with African-Americans reporting more clinical pain, lower pain thresholds for ischemic and cold pressor pain, higher pain-related disability, and higher pain unpleasantness than Caucasians. 4,5,8,12,13,33,34,40,41 Other research groups have not found race differences in pain severity. 9,21 Although such research may enhance treatment and prevention with diverse groups, it is essential to also examine variables that might moderate racial group differences in the pain experience.…”