A descriptive analysis of work-related hospitalizations among Hispanic and non-Hispanic workers in Texas
Background. Texas has a unique opt-in workers' compensation insurance system which allows employers of any size to provide alternative plans or forgo any type of coverage. Few data exist on how the Texas workers' compensation system affects injured workers. Aims. The purpose of this study was to determine if an ethnic disparity exists in workers' compensation insurance coverage for work-related injuries resulting in a hospitalization in Texas. The secondary goal was to determine if work-related hospitalizations among Hispanics differ in severity as compared to non-Hispanics. Methods. Work-related records were extracted through the identification of two work-related variables and through the identification of workers' compensation as a primary payer. Percentages and 95% confidence intervals were utilized to describe the hospitalizations, and adjusted and unadjusted prevalence ratios were calculated using Cochran-Mantel-Haesznel chi squared tests to compare between Hispanic and non-Hispanic workers. Results. A total of 9,447 work-related hospitalizations were identified among workers aged 18-74 years, with Hispanic workers accounting for 34.2% of the total. According to the 2013 American Community Survey, 35% of adults 18 years of age and over in Texas were Hispanic.1 Hispanic workers were more likely to be uninsured (6.2%, 95% CI 5.4-7.1) compared to non-Hispanics (4.6%, 4.1-5.1). Hispanic workers also had a substantially higher proportion of representation in the workers' compensation group who did not report their condition as work-related (44.0%, 42.3-45.8) compared to non-Hispanic workers (35.2%, 34.1-36.4). No statistically significant difference was observed between Hispanic and non-Hispanics in the proportion with workers' compensation coverage. Statistically significant ethnic differences in injury and illness severity were not observed. However, non-Hispanics who were uninsured had a 3.3 (1.5-7.0) times higher prevalence of extremely severe injuries and 2.3 (1.2, 4.0) times higher prevalence of extremely severe illnesses. Overall, workers with workers' compensation insurance but who did not report their condition as work-related and uninsured workers comprised just 43.3% of all hospitalizations but accounted for 71.4% of all recorded fatalities. Conclusions. There is a paucity of research that has examined Texas' unique workers' compensation system and its impact on injured workers. Underreporting of work-related hospitalizations emerged as a critical issue in this study, with Hispanic workers and those with the most severe injuries being the most likely to not report their condition as work-related. Further research into how Texas' unique workers' compensation system affects injured and ill workers is urgently needed before other states consider implementing similar systems.
Occupational health|Hispanic American studies|Epidemiology
Boggess, Bethany, "A descriptive analysis of work-related hospitalizations among Hispanic and non-Hispanic workers in Texas" (2015). Texas Medical Center Dissertations (via ProQuest). AAI1597520.