240640 Association of race, cultural factors, and health related quality of life

Tuesday, November 1, 2011: 2:48 PM

Larissa Myaskovsky, PhD , Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
Kelly Burkitt, PhD , Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
Denise C. Fyffe, PhD , Spinal Cord Injury Research Laboratory, The Kessler Foundation Research Center, West Orange, NJ
Alison Lichy, PT, NCS , Neuroscience Research Center, National Rehabilitation Hospital, Washington, DC
Inger Ljungberg, MPH , SCI Research Center, National Rehabilitation Hospital, Washington, DC
John Kloke, PhD , Center for Research on Healthcare, University of Pittsburgh, School of Medicine, Pittsburgh, PA
Galen Switzer, PhD , Center for Research on Health Care, Pittsburgh, PA
Michael Fine, MD MPH , Center for Health Equity Research Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
Michael Boninger, MD , Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA
This cross-sectional, multi-site study was designed to examine the association of race and cultural factors (experience of discrimination, perceived racism, healthcare system distrust, health literacy, communication with provider) with quality of life (QOL) factors (participation, life satisfaction, perceived health status) among people with spinal cord injury (SCI).

Structured questionnaires were used to interview 275 people with SCI at 6 national Spinal Cord Injury Model Systems centers. Outcome measures included: participation (Craig Handicap Assessment and Reporting Technique Short Form); satisfaction (Satisfaction with Life Scale); and, perceived health status (two items from the SF-36).

African Americans (n=96) with SCI reported more experiences of discrimination in healthcare, greater perceived racism, more healthcare system distrust, and lower health literacy than did Whites (n=156) (ps range <.001 to <.05). Participants who reported experiencing more discrimination in health care reported better occupational functioning (OR=1.5, p<.05). Those who perceived more racism in healthcare settings reported better occupational functioning (OR=1.65, p<.05) and greater perceived health (=.36, p<.05). Those who reported more distrust in the healthcare system reported better current health compared to 1 year ago (=.38, p<.05). Those who reported better communication with their healthcare provider reported higher levels of mobility (OR=1.5, p<.05) and better general health (=.27, p<.05).

These associations are different from those reported in other clinical study populations examining racial differences in health outcomes. Taken together, it is possible that possessing high levels of certain cultural factors may be associated with an increase in participation and functioning, and improvements in perceptions of well-being.

Learning Areas:
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Compare cultural factors between White and African American people with Spinal Cord Injury. 2. Compare quality of life outcomes between White and African American people with Spinal Cord injury. 3. Identify cultural factors related to quality of life outcomes in people with Spinal Cord Injury.

Keywords: Social Inequalities, Quality of Life

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an assistant professor of medicine and psychiatry who conducts research on racial disparities in healthcare processes and outcomes.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.