Association of Race, Socioeconomic Status, and Health Care Access With Pressure Ulcers After Spinal Cord Injury
Archives of Physical Medicine and Rehabilitation,  Clinical Article

Saunders LL et al. – Even after accounting for health care access, household income, a measure of socioeconomic status (SES), remained significantly associated with PU outcomes after spinal cord injury (SCI); however, race became nonsignificant.

Methods
  • Persons with traumatic SCI who :
    • Had residual effects from their injury
    • Were 18 years or older at the time of the survey
    • Were a year or more postinjury at the time of survey (N=2549).
  • Outcomes were measured by a mail-in survey: having a current PU (yes vs no), having a PU in the past year with or without reduced sitting time (no PU, no reduced sitting time, month or less, ≥5wk), and having at least 1 PU surgery since SCI onset (yes vs no).

Results
  • Of participants, 39.3% reported a PU in the past year, 19.9% had a current PU, and 21.9% reported having had surgery for a PU since their SCI onset.
  • While race was preliminarily associated with each PU outcome, it became nonsignificant after controlling for SES and health care access.
  • In each analysis, household income was significantly associated with PU outcomes after controlling for demographic and injury factors and remained significant after accounting for the health care access factors.
  • Persons with lower income had higher odds of each PU outcome.
  • Health care access was not consistently related to PU outcomes.

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