Understanding disparities in traumatic brain injury outcomes

Traumatic brain injury (TBI) is a major cause of death and acquired disability for children in the United States. TBI’s effects are particularly profound for Hispanic children. Compared to non-Hispanic children, they have lower function and quality of life persistently up to three years after their injury. The Jimenez Lab investigated through a series of studies what causes these disparities and is developing solutions that could help more children with TBIs live healthier, happier lives.

Pinpointing how TBIs impact Hispanic families

Our group was the first to investigate disparities in disability after TBIs among Hispanic children. Our research has found important long-term disparities and is uncovering barriers that make it harder for Hispanic children to get the rehabilitation services they need. We have shown that:

Hispanic children who sustain TBIs have lower quality of life, participate in fewer childhood activities and are less able to communicate and take care of their daily needs than non-Hispanic white children with similar injuries.

Importantly, we also found that these disparities were not present at the time of discharge from inpatient rehabilitation facilities, and that Hispanic children recovered at the same pace as non-Hispanic children when receiving equal inpatient care.

Many Medicaid-insured children with TBI do not receive sufficient rehabilitation services after being discharged from the hospital. One of our studies found in 9,361 Medicaid-insured children, only 29% received outpatient rehabilitation therapy during the year after their TBI. Hispanic children with TBI were less likely than non-Hispanics to receive speech therapy.

In Washington state, children who suffer TBIs and live in households with limited English proficiency face significant barriers to rehabilitation services. Less than 20% of providers accept children with Medicaid and provide language interpretation. Adjusting for education and Medicaid status, children from Spanish-speaking families have significantly longer travel times to available services.