Labour market participation after spinal cord injury. A register-based cohort study

Abstract

Study design A register based cohort study. Objectives To investigate labour market participation following spinal cord injury (SCI) and to describe the impact of personal and SCI characteristics. Setting Norway. Methods Persons registered with SCI in the Norwegian SCI registry 2011–2017, and matched reference individuals without SCI from the general population (named controls) were followed for up to six years after injury using national registry data on employment, education, income, and social security benefits. Main measures of labour market participation were: (1) Receiving any amount of pay for work, and (2) Receiving sickness and disability benefits. Results Among the 451 persons with SCI (aged 16–66 years and working before injury), the estimated percentages receiving pay for work and sickness and disability benefits in the sixth years after injury were 63% (95% CI 57–69) and 67% (95% CI 61–72). Corresponding percentages for the controls (n = 1791) were 91% (95% CI 90–93) for receiving pay for work and 13% (95% CI 12–15) for receiving sickness and disability benefits. Among persons with SCI, less severe neurological outcome, higher level of education, younger age at injury, and a stronger pre-injury attachment to employment (higher employment income, having an employer, less receipt of benefits), were associated with higher labour market participation. Conclusion SCI substantially decreased labour market participation up to six years after injury compared to matched controls. Even if a relatively large proportion of persons with SCI remained in some degree of work activity, more than half did so in combination with receiving benefits.

Realizing the potentials of a National Spinal Cord Injury Registry – 10 years of experiences

“…In Norway, we have the unique opportunity to link data from different registers. Combining data from NorSCIR with other registry data has been effective to find answers to other research questions, for example regarding labour market participation and, the use of sickness and disability benefits in the SCI population (22). Thus, through research on data from the registry, one can examine both epidemiology, and study associations between the impact of SCI and the provided care, and different short-and long-term outcomes.…”

Traumatic Cervical Spinal Cord Injury and Income and Employment Status

“…We chose a study period of 7 years, from Y −2 to Y 5, because the 2 years prior to injury helped to establish a preinjury trend for analysis and prior studies suggest that SCI survivors are able to partially regain employment by the fifth year after injury. 31 , 32 , 33 Finally, we matched patients in the injured group with those in the comparison group on baseline (Y −1) demographics (age, sex, and province of tax filing) and baseline earnings–associated variables (earnings in Y −1, employment status in Y −1, and self-employment status). Matching was performed using coarsened exact matching (eMethods 2 in Supplement 1 ).…”

Disability, Unemployment, and Inequality: A Cross-Country Comparison of the Situation of Persons With Spinal Cord Injury

“…12 Internationally, the employment rate of persons with SCI is, on average, 38 percent and is markedly lower than in the general population 12 ; however, these numbers vary widely between countries. 16,17 The benefits of labor market participation are well known, 18,19 including better health, 4,20,21 financial self-sufficiency, 22 improved quality of life, 22,23 and increased life expectancy. 22 Nevertheless, current labor market research lacks international comparisons and is mostly focused on the participation of the average individual, but it does not disaggregate the results by socioeconomic group such as income level, which reveals different realities and policy needs between and within countries.…”