Severity of Traumatic Brain Injury Affects Veterans’ Employment

Posted on: October 20, 2014 Topics: health law, policy & management, TBI, traumatic brain injury, veterans

A high percentage of Iraq and Afghanistan veterans who were evaluated at the Department of Veterans Affairs (VA) and diagnosed with moderate to severe traumatic brain injury (TBI) suffer from at least one suspected psychiatric condition and are unemployed – findings suggesting that they need multi-faceted help to readjust to civilian life, a new study led by a BUSPH researcher shows.

The study, published in the Journal of Head Trauma Rehabilitation, found that veterans’ employment status was influenced by the severity of their deployment-related TBI. About 45 percent of those with moderate or severe TBI were unemployed, compared to about one-third of those with mild TBI or no TBI history. The researchers analyzed data from more than 11,000 veterans who completed a comprehensive TBI evaluation from the VA.

TBI is a “signature injury” of the Iraq and Afghanistan wars, largely caused by blasts from improvised explosive devices (IEDs). Mild TBI is the most common severity type, accounting for more than 80 percent of all cases treated.

The study found that veterans with mild TBI were no more likely to be unemployed than patients without any TBI history. But veterans who were unemployed and not looking for work were more likely to have experienced moderate to severe TBI; have lower education levels; suffer from suspected psychiatric conditions such as posttraumatic stress disorder, anxiety and depression; be aged 40 or older; and be divorced, separated, or widowed. Also, veterans who were active duty were more likely to be unemployed than those who served in the National Guard/Reserves.

The research team — led by Terri K. Pogoda, a research assistant professor in health policy and management at BUSPH and a researcher with the VA Boston’s Center for Healthcare Organization and Implementation Research – said that the findings “underscore the need to investigate why unemployment rates are high among this cohort, and what assistance can be provided to address veterans’ multiple needs.”

More than 80 percent of the sample group had at least one suspected psychiatric condition, and 42 percent had two or more. Multiple conditions were most evident among those who were unemployed and not looking for work.

“Simultaneously addressing health-related, educational, and/or vocational needs may fill a critical gap for helping veterans readjust to civilian life and achieve their academic and vocational potential,” the research team said.

The study team included researchers from the BU School of Medicine, Virginia Commonwealth University, University of Hawaii at Manoa, Honolulu, the Defense Resources Management Institute, and the National Center for Posttraumatic Stress Disorder.

Submitted by Lisa Chedekel