Predictors of Employment Status in Male and Female Post-9/11 Veterans Evaluated for Traumatic Brain Injury

The article of record as published may be found at http://dx.doi.org/10.1097/HTR.0000000000000404 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 crosssectional 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. Investigator Initiated Research Awards #11-078 and #11-358 Career Development Award (10-029) Presidential Early Career Award for Scientists and Engineers (USA 14-275) National Institute of Mental Health (5R25MH08091607) VA HSR&D Service, Quality Enhancement Research Initiative This material is based upon work supported in part by the Department of Veterans Affairs (VA),Veterans Health Administration, Office of Research and Development Health Services Research and Development (HSR&D) service’s Investigator Initiated Research Awards #11-078 and #11-358 (Dr Pogoda). Dr Iverson’s contribution was supported by her HSR&D Ca- reer Development Award (10-029) and a Presidential Early Career Award for Scientists and Engineers (USA 14-275). Dr Iverson is an investigator with the Implementation Research Institute (IRI) at the George Warren Brown School of Social Work, Washington University in St Louis, through an award from the National Institute of Mental Health (5R25MH08091607) and VA HSR&D Service, Quality Enhancement Research Initiative.