Socioeconomic Status

Very little research exists examining the effect of socioeconomic status (SES) on rehabilitation outcomes in SCI. However, those with a greater SES may experience enhanced well-being, participation, and employment (Botticello et al. 2011; Botticello et al. 2012). As discussed previously, SES may have more of an impact on rehabilitation outcomes in relation to education and income than race. In this sense, understanding the role of SES in access to continuing care is important to improve rehabilitation outcomes and inform health policy within SCI populations, particularly for individuals with low SES.

Discussion

Gupta et al. (2008) compared socioeconomic status among individuals with traumatic and non- traumatic SCI. They found no significant differences in SES between groups, suggesting that type of injury is independent of SES. Although, type of injury may be independent of SES, Chhabra and Bhalla (2015) found that financial constraints affect all components of SCI management across all SES groups except for those with the highest SES. However, the generalizability of this study to populations outside of India needs to be investigated in further studies. Despite this, SES is an important factor to consider when determining management strategies beyond outpatient rehabilitation.

Conclusions

There is level 3 evidence (from one case control study: Gupta et al. 2008) that socioeconomic status has no effect on type of injury.

There is level 5 evidence (from one observational study: Chhabra & Bhalla 2015) that financial constraints experienced by patients affect access to SCI care in all socioeconomic status groups, except those with the greatest socioeconomic status.