The effects of race/ethnicity, comorbid disabilities, and vocational rehabilitation services on employment outcomes of individuals with traumatic brain injury

Individuals with TBI are among the fastest growing population served in the state – federal vocational rehabilitation programs. The increasing rates of individuals with TBI accessing VR programs and the higher rates of unemployment among this population have been reported in the literature. Using the Rehabilitation Services Administration National Case Services Report (RSA-911) fiscal year (FY) 2012, this study examined the predictors of employment outcomes. In order to determine the effective VR services across groups, the moderating effects of race/ethnicity, comorbid disabilities on the effects of VR services on employment outcomes of individuals with Traumatic Brain Injury (TBI) were also examined. A logistic regression was run and results showed a significant disparity in the rate of successful employment outcomes of individuals who are White versus those individuals from racially/ethnically diverse backgrounds, especially Blacks. After controlling for demographic characteristics, on-the-job support, job placement, and on-the-job training emerged as the most important positive set of VR services predictors of successful employment outcome, regardless of race/ethnicity. Maintenance, assistive technology, and job search assistance emerged as the second set of positive predictors. Diagnosis and treatment service was significantly negatively related to employment outcome, regardless of the race/ethnicity of the individual with TBI. College training and assessment services were found to significantly increase the odds of being successfully employed for Blacks compared to the odds of being successfully employed for individuals who are White. Transportation and supported employment services significantly increased the odds of being successfully employed for individuals from ‘Other’ ethnic minority groups (i.e., American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islanders) compared to the odds of being successfully employed for those individuals who are White. VR Service variables were stronger predictors of successful employment than demographic variables and pre-employment status as application. Depression was negatively related to successful employment outcome, but did not moderate the effect of VR services on employment outcome. Limitations, implications, and directions for future studies are also discussed.