04/01/2024
Intersectionality of Systemic Disadvantage on Mortality and Care Following TBI
Background: Health disparities for people of color (POC) are well established, but often focuses on only one marginalized identity. However, people often experience intersectional marginalized identities that may compound disparities.
Methods: We examined patterns of intersectionality in TBI and if health outcomes differed for the groups.
Used routinely collected clinical data from electronic health record and local trauma registry for ~11,000 adults admitted to Harborview Medical Center with TBI between 2012-2023
Results: Results demonstrate health inequities in mortality and access to inpatient rehabilitation following TBI
Mortality: Groups experiencing more systemic disadvantage experienced higher rates of mortality during HMC hospitalization following TBI.
Opioid Usage: Older adults received lower daily morphine equivalent doses
This reflects the current clinical practice guidelines regarding dosing of opioids for older populations
Discharge Location: Groups with older adults were more likely to discharge to other care facilities than to inpatient rehabilitation.
Discussion: While many inequities may be related to systemic racism, our findings suggested an additive, deleterious effect for patients who belonged to multiple historically disadvantaged groups.
Research Study Authors: Amy J. Starosta, Felicia Mata-Greve, Andrew Humbert, Zihan Zheng, Maria G Prado, Margaret A Au, Brenda Mollis, Kari A. Stephens, Jeanne M. Hoffman
Image Description: There is a bar chart that shows the survival rate and discharge location (other care facility, Inpatient Rehabilitation, Other) of adults of these four identities: white adult, POC Adult, POC Non-english speaking older adult, and white English speaking older adult. There was a 10% greater mortality rate for the POC, non -English speaking older adults and White, English-speaking older adults compared to the POC adults and white, English speaking adults. The POC- non-English speaking older adults were less likely to discharge to inpatient rehabilitation and more likely to discharge to another care facility