Citation

Amara JH, Stolzmann KL, Iverson KM, Pogoda TK. J. Head Trauma Rehabil. 2019; 34(1): 11-20.

Affiliation

Defense Resources Management Institute, Naval Postgraduate School, Monterey, California (Dr Amara); VA Health Services Research & Development Service Center for Healthcare Organization and Implementation Research (Ms Stolzmann and Dr Pogoda) and Women's Health Sciences Division of the National Center for PTSD (Dr Iverson), VA Boston Healthcare System, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Massachusetts (Dr Iverson); and Department of Health Law, Policy & Management, Boston University School of Public Health, Massachusetts (Dr Pogoda).

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000404

PMID

29863619

Abstract

OBJECTIVES: The goal of this study was to investigate predictors of employment status in male and female post-9/11 Veterans evaluated for traumatic brain injury (TBI) in the Veterans Health Administration. Prior research suggests there are gender differences in psychosocial characteristics among this cohort.

METHODS: This was a cross-sectional analysis of post-9/11 Veterans who completed a TBI evaluation between July 2009 and September 2013.

RESULTS: Women had lower prevalence of deployment-related TBI (65.5%) compared with men (75.3%), but the percentages of those unemployed across the TBI diagnostic categories were similar for men (38%) and women (39%). Adjusted log-binomial regression found that unemployment was significantly associated with age, education, marital status, moderate/severe TBI, suspected posttraumatic stress disorder, depression, and drug abuse/dependence, and neurobehavioral symptom severity for men, whereas for women only more severe affective and cognitive symptoms were associated with unemployment.

CONCLUSIONS: Although the unemployment rate was similar across gender, there was a clearer pattern of demographic and health factors, including TBI severity, that was significantly associated with employment status in men. There may be other factors contributing to the female Veteran unemployment rate, underscoring the need to investigate unique contributors to unemployment, as well as how treatment and employment services can be expanded and tailored for post-9/11 Veterans.

Language: en