Disparities in subjective well-being, participation, and health after spinal cord injury: A 6-year longitudinal study

Background: Our purpose was to identify disparities in subjective well-being, participation, and general health over a 6-year period as a function of race-ethnicity and gender among participants with spinal cord injury (SCI). Design: A multi-site, longitudinal study with stratified sampling based on gender and race. Methods: There were 250 participants from three model SCI systems who participated during two times of measurement separated by a 6-year interval. There were similar portions of Caucasian (n =62), African-American (n =61), American Indian (n =56), and Hispanic participants (n =71). Approximately 43.1% of the sample was women. The measures included: (a) subjective well-being--the Life Situation Questionnaire – Revised and the Older Adult Health and Mood Questionnaire, (b) participation—select items from the Craig Handicap Assessment and Reporting Technique, and (c) health—select items from the Behavioral Risk Factor Surveillance System. Results: MANOVA revealed significant effects for race-ethnicity (between subjects effect) and time (within subjects effect) but not for gender. All interaction effects were non-significant. Caucasians reported the best subjective well-being followed by African-Americans. Caucasians reported more hours out of bed than either African-Americans or Hispanics. Economic self-sufficiency improved over time, whereas self-rated adjustment and time out of bed declined. Conclusion: Racial-ethnicity disparities in outcomes did not systematically increase or diminish over time, suggesting that, once developed, disparities in outcomes are unlikely to change in the absence of intervention.