Understanding the Social Determinants of Healthcare Access After TBI

Reliable access to quality healthcare is indisputably associated with positive health outcomes. Unfortunately, access to healthcare can be challenging for persons with TBI due to sociodemographic and injury-related issues. Racial/ethnic minority status is linked with more barriers to healthcare access and increased risk for comorbid conditions that require additional management (i.e. cardiovascular disease, diabetes). Additionally, racial/ethnic disparities in healthcare access tend to be magnified among persons with disabilities, with ample evidence for disparities after TBI, especially among Black and Hispanic persons. Poor healthcare access in these populations has even been linked with higher mortality rates.

Using a mixed-methods design, with input from diverse individuals with brain injury and key stakeholders, the proposed study will: (1) improve our understanding of the healthcare access barriers and facilitators for persons with TBI, (2) build upon previous work at our center to adapt a measure of healthcare access and quality to maximize its relevance to the TBI community, and (3) examine how access to healthcare is associated with other Social Determinants of Health (i.e., education, neighborhood characteristics, social/community context, economic stability) and participant global health in a comprehensive regression model.