Do racial differences exist for vocational rehabilitation applicants with schizophrenia? A propensity score matched case-control study

Background: The COVID-19 pandemic and the Black Lives Matter movement revealed American society's unconscious bias and systemic discrimination against Black/African Americans and other minority groups, including people with disabilities. These disparities are particularly pronounced for individuals with intersecting identities, such as race, gender, disability, and poverty, leading to racism and ableism. Objective: This case-control study investigated racial disparities in acceptance rates for state vocational rehabilitation (VR) services among applicants with schizophrenia. Method: Utilizing the U.S. Department of Education Rehabilitation Services Administration (RSA-911) dataset for the program year 2018, we compared acceptance rates between Black/African American and White American VR applicants with schizophrenia. Propensity score matching (PSM) was performed to create a White applicant with schizophrenia (control, n = 2,971) group and a black applicant with schizophrenia (treatment, n = 2,971) group with similar demographic characteristics to control selection bias. Results: Our findings indicated no significant difference in VR acceptance rates between the two groups: 73.7% for Black/African Americans with schizophrenia and 72.4% for White Americans with schizophrenia. Conclusions: This outcome contrasts with previous studies that suggest racial bias still exist in state VR services. Our findings may indicate that, when selection bias is controlled, acceptance rates for VR services between White Americans and Black/African Americans with disabilities may be comparable. This study contributes to the ongoing dialogue on racial equity in disability services, and it presents an alternative research method for conducting racial difference studies in VR.