With the current high crime rates and the rising expense of medical care, African Americans are at considerable risk for severe injuries and medical problems. One concern is that treatment is not received until African Americans are more seriously injured or unhealthy than European Americans in the same communities. This study examines similarities and differences among the health status of African American and European American men and women at the onset of neurological rehabilitation. The focus is on neurological insults and disease, including stroke, heart attack, and brain injury.

Participants were 300 consecutive first-time rehabilitation patients in nine hospital and private practice settings.

Hypothesis: Neuropsychological and physical profiles of the female and male rehabilitation patients are significantly different.

Participants:

300 consecutive first-time admission rehabilitation patients
9 hospital and private practice settings in seven U. S. states

Demographic analysis:
Women were significantly older (64.5±15.6 years; t = 3.66, p < .001) and had more education (12.0±2.7 years; n.s.) than men (57.4±17.6 years of age; 11.7±2.9 years of education). Ethnic-gender groups included:

7.0% African American female
10.4% African American male
40.1% European American female
42.5% European American male
 

Each female participant entered treatment with at least 4 diagnoses, whereas most men had only 2 diagnoses. Men entered rehabilitation sooner after seeking acute medical care than women. This is consistent with gender differences in neuropsychological functioning.

They were tested with the Ackerman-Banks Neuropsychological Rehabilitation Battery. Discriminant analyses on the normative sample indicated that the test did not discriminate among ethnic, gender, and ethnic-gender groups. Multiple and univariate analyses of variance were used to determine scale performance differences among ethnic, gender, and ethnic-gender groups.

Significant ethnic-gender differences were found on three (3) of the scales:

proprioception (F_(1,295)=5.18, p <.05),
right-brain controlled balance (F_(1,295)=4.04, p <.05), and
impulsivity (F_(1,295)=3.85, p <.05).

No ethnic differences were found on any of the 43 scales. Examination of the test scoring patterns revealed that all differences were due to either specific ethnic-gender groups or were accounted for by gender.

Six (6) gender differences were found in:

right-brain controlled balance (F_(1,295)=21.54, p <.001),
left-brain controlled balance (F_(1,295)=11.78, p <.001),
proprioception (F_(1,295)=10.44, p <.001),
left-right confusion (F_(1,295)=7.03, p <.01),
dysarthria (F_(1,295)=4.82, p <.05), and
tactile input (F_(1,295)=4.42, p <.05).

African American women patients were older, more educated, more likely to be widowed, and much more physically and neuropsychologically disabled than other patients. African American men patients were younger, had less education, were more impulsive, more likely to be divorced or separated, and did not wear their glasses for reading or watching television.

These data support the hypothesis that African Americans, particularly African American women, are more disabled than other people before being referred for rehabilitation. It also appears that African American men become severely ill and need comprehensive rehabilitation at younger ages than other people.
 

This paper was presented at the April 1996 convention Traumatic Brain Injury: Models and Systems of Care in Washington, DC. The abstract was published in the proceedings of that conference. 

Last Updated: 12/26/00