Supplemental Materials Survey Questions for Secondary Outcomes:
We considered a respondent to have one of the following six secondary outcomes if they
answered yes to any of the associated survey questions listed below. Years analyzed: 2011-2017.
1. Food Insecurity
These next questions are about whether you were always able to afford the food you needed in the last 30 days. I'm going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for [you/your family] in the last 30 days. … Was that often true, sometimes true, or never true for [you/your family] in the last 30 days?
[I/We] were worried whether [my/our] food would run out before [I/we] got money to buy more.
The food that [I/we] bought just didn't last, and [I/we] didn't have money to get more.
[I/We] couldn't afford to eat balanced meals. Cut size or skipped meals because not enough money
Stand-alone questions
In the last 30 days, did [you/you or other adults in your family] ever cut the size of your meals or skip meals because there wasn't enough money for food?
In the last 30 days, did you ever eat less than you felt you should because there wasn't enough money for food?
In the last 30 days, did you lose weight because there wasn't enough money for food?
In the last 30 days, did [fill 1: you/you or other adults in your family] ever not eat for a whole day because there wasn't enough money for food?
At any time during [fill 1: last calendar year in 4-digit format], did [fill 2: you/any family members living here] receive [fill 3: food stamp benefits/SNAPNAME or food stamp benefits]?
At any time during [fill1: last calendar year in 4-digit format] did [fill2:
you/anyone in your family] receive benefits from the WIC program, that is, the Women, Infants and Children program?
2. Difficulty Accessing Health Care (years 2011-2017) During the past 12 months, …
did you have any trouble finding a general doctor or provider who would see you?
were you able to find a general doctor or provider who could see you? (included if answered No)
were you told by a doctor’s office or clinic that they did not accept your health care coverage?
Have you delayed getting care for any of the following reasons in the past 12 months?
You couldn't get through on the telephone.
You couldn't get an appointment soon enough.
Once you get there, you have to wait too long to see the doctor.
The (clinic/doctor's) office wasn't open when you could get there.
You didn't have transportation.
3. Difficulty Affording Health Care
During the past 12 months, was there any time when you needed any of the following, but didn't get it because you couldn't afford it?
Prescription medicines
Mental health care or counseling.
Dental care (including check ups).
Eyeglasses
To see a specialist?
Follow-up care.
Stand-alone question:
How worried are you right now about not being able to pay medical costs for normal healthcare? (very worried and somewhat worried only)
4. Medical Debt (years 2011-2017)
In the past 12 months did [you/anyone in the family] have problems paying or were unable to pay any medical bills? Include bills for doctors, dentists, hospitals, therapists, medication, equipment, nursing home or home care.
[Do you/Does anyone in your family] currently have any medical bills that you are unable to pay at all?
[Do you/Does anyone in your family] currently have any medical bills that are being paid off over time? This could include medical bills being paid off with a credit card, through personal loans, or bill paying arrangements with hospitals or other providers. The bills can be from earlier years as well as this year.
5. Foregone care (years 2011-2017) During the past 12 months,
[have you delayed seeking medical care/has medical care been delayed for anyone in the family] because of worry about the cost?
was there any time when [fill1: you/someone in the family] needed medical care, but did not get it because [fill2: you/the family] couldn't afford it?
6. Disability (years 2011-2017)
All persons less than 65 years of age who received Social Security or Railroad Retirement income as a disability benefit in the last calendar year: Did
[you/ALIAS] receive this benefit because [you are/he is/she is] disabled?
Because of a physical, mental, or emotional problem, [fill1: do you/does anyone in the family] need the help of other persons with personal care needs, such as eating, bathing, dressing, or getting around inside this home?
How long have you had the injury that caused your limitation? (>95 days)
By yourself, and without using any special equipment, how difficult is it for you to... ...Walk a quarter of a mile - about 3 city blocks? (Very difficult or can't do at all)
Table 3a
N 778 426,403
Weighted N 350,737 194,764,032 Trauma
Cohort (%)
Matched Cohort (%)
Trauma vs Matched Cohort Unadjusted OR
(95% CI)
Adjusted OR (95% CI)
p- value Food Insecurity
51.9
27.9 2.79 (2.35, 3.31) 1.95 (1.53,
2.49) <.001 Difficulty
Accessing Health
Care 39.1
28.3
1.63 (1.22, 2.17)
1.30 (0.94,
1.80) 0.118
Difficulty Affording Health Care
51.4 38.4 1.70 (1.29, 2.23) 1.28 (0.94,
1.75) 0.124
Medical Debt 53.5 30.4 2.63 (2.21, 3.13) 2.62 (2.17,
3.15) <.001 Foregone Care due
to Cost
23.4 11.5 2.36 (1.92, 2.91) 1.82 (1.45,
2.28) <.001 Disability
55.9 7.1
16.48 (13.74, 19.77)
16.97 (12.40,
23.24) <.001
Table 3a. Secondary Outcomes Without Propensity Score Matching. Injured patients were compared to all non-injured patients ages 18-64 in the 2008-2017 National Health Interview Survey in this sensitivity analysis. All analyses were adjusted for survey year, days since discharge, age, sex, census region, race/ethnicity, income, education, insurance status, marital status, and family size.
Table 3b
N 681 3,352
Weighted N 310,573 1,551,973
Trauma Cohort (%)
Matched Cohort (%)
Trauma vs Matched Cohort Unadjusted OR
(95% CI)
Adjusted OR (95% CI)
p- value Food Insecurity 51.0 41.2 1.48 (1.23, 1.79) 1.88 (1.45,
2.43)
<.001 Difficulty Accessing
Health Care
39.6 37.5
1.10 (0.70, 1.73)
1.28 (0.75,
2.20) 0.365
Difficulty Affording Health Care
51.4 54.1 0.90 (0.53, 1.51) 1.09 (0.626,
1.90) 0.756
Medical Debt 55.9 35.0 2.36 (1.93, 2.88) 2.71 (2.19,
3.35) <.001 Foregone Care due
to Cost
23.9 15.3 1.74 (1.37, 2.20) 1.78 (1.39,
2.29) <.001 Disability
55.3 21.3 4.57 (3.74, 5.59)
11.43 (8.33,
15.69) <.001
Table 3b. Secondary Outcomes with Expanded Propensity Score Matching. Injured patients were compared to non-injured patients with extended match criteria ages 18-64 in the 2008-2017 National Health Interview Survey. The non-injured comparison group in this sensitivity analyses was created by matching on survey year, age, sex, census region, race/ethnicity, income
category, and insurance category. After matching, all analyses were subsequently adjusted for survey year, days since discharge, age, sex, census region, race/ethnicity, income, education, insurance status, marital status, and family size.
