Racial-ethnic variations in paid and unpaid caregiving: Findings among persons with traumatic spinal cord injury


The effects of race-ethnicity on the use of paid and unpaid caregivers for those with spinal cord injury (SCI) have received little attention in the literature.


Compare the amount of paid and unpaid caregiver hours received and sources of caregiving between non-Hispanic White and non-Hispanic Black participants with SCI, controlling for demographic, injury-related, and economic variables.


Participants were identified from a large specialty hospital. Self-report data were collected by mail. Five aspects of caregiving were assessed: (a) paid assistance hours, (b) satisfaction with care, (c) unpaid assistance hours, (d) sources of informal care, and (e) evaluation of whether needs were met.


Whites were more satisfied with paid care. Approximately 43.4% of Whites received informal care from their spouse every day, 14.7% higher than Blacks. Blacks were more likely to receive informal care from other family members, friends, church, and others. When controlling for gender, injury severity, chronological age, and years post injury, Blacks reported 1.50 more paid assistance hours (95% CI, 0.31–2.68 hours) and 1.83 less unpaid assistance hours than Whites (95% CI, 0.25–3.41 hours). Differences diminished and were not statistically significant after adding marital status and income into regression models.


The results did not provide strong evidence of racial disparities regarding caregiver assistance for those with SCI. Level of income appears to be directly related to satisfaction of quality caregiving and the use of paid versus unpaid care