Labor Market Integration of People with Disabilities: Results from the Swiss Spinal Cord Injury Cohort Study (original) (raw)
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Spinal Cord, 2012
Study design: Cross-sectional survey. Objectives: To establish labour market participation figures of persons with spinal cord injury (SCI) living in Switzerland and to investigate determinants and consequences of having paid work. Setting: Community. Methods: A survey among members of the Swiss Paraplegic Association was performed in 2008. Inclusion criteria were: SCI of traumatic or non-traumatic origin, minimum age of 18 years, and living in the community for at least 1 year. A total of 559 persons with SCI returned the questionnaire (response rate 27%), of which 495 (24%) fulfilled the eligibility criteria. Bivariate and logistic regression analyses were performed based on theoretical considerations and relevant determinants found in the literature. Results: Of the respondents of working age, 63.8% were involved in gainful employment. No significant difference between persons with para-and tetraplegia was observed. Logistic regression showed that employment was associated with age, time since onset of SCI, having worked at 2 years after initial rehabilitation, having received vocational counselling, having less pain, more years of education and more perceived importance of work. Working persons achieved a significantly higher total income. The most important reasons to work were not financial, but rather of social nature. Barriers to work were primarily health-related. Conclusions: We found a relatively high employment rate among the studied persons with SCI living in Switzerland. However, because of the low response, it is difficult to generalise this finding.
Labour market outcomes for people with a spinal cord injury
Economics & Human Biology, 2010
In this paper we examine the labour market outcomes (participation, employment and earnings) of people with spinal cord injuries (SCIs), concentrating on the role of public and private forms of assistance ("Lifestyle Support Packages") with activities of dialing living. We designed and administered the Spinal Injuries Survey Instrument to 250 individuals with SCIs in Queensland. Using a matched sampling approach and written, web-and telephone responses, as well as financial incentives, we achieved a response rate of 72 per cent. In anticipation of the substantive econometric issues associated with studies of this kind, we included items to measure otherwiseunobserved sources of heterogeneity, including measures of "attributional style" from field of psychology. Our sampling strategy also involved the collection of data that might serve as suitable instruments for our econometric work. The empirical results reported in this paper include bivariate and univariate probit model results, treatment effect and linear (OLS) regression and Heckman sample selection models. Econometric testing suggests that our sampling approach absorbed much of the heterogeneity in the sample that would typically be unobserved by researchers, but may be observed by others (e.g., employers). Our results uniformly suggest that the most important determinants of post-SCI employment outcomes are years of education and post-injury training and education, which exert a positive influence. We find a weak negative correlation, ceteris paribus, of public support packages on participation and employment outcomes.
Labour market participation after spinal cord injury. A register-based cohort study
Spinal Cord
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) fo...
The Journal of Spinal Cord Medicine, 2019
Objective: To compare pre-and post-injury job type distributions of individuals with spinal cord injury (SCI) living in Switzerland. Design: Cross-sectional, self-report survey. Setting: Community. Participants: Two hundred sixty-three individuals reporting a pre-and 677 a post-injury job title in the Swiss SCI Cohort Study community survey. Interventions: Not applicable. Outcome Measures: Job titles were elicited by free-text questions and classified using the International Standard Classification of Occupations (ISCO-08). Frequencies across ISCO-08 major groups were calculated and compared to Swiss labor market statistics for 1995 and 2011. Results: Compared to pre-SCI, Professionals (16.3% vs 31.2%) and Clerical Support Workers (11.7% vs 19.1%) were more prevalent and Crafts and Related Workers (26.5% vs 5.4%) less common post-injury. Except for Clerical Support Workers, these results reflect recent structural changes in the Swiss labor market. Conclusion: The higher post-SCI prevalence of jobs predominantly requiring cognitive and communication skills compared to rather physically oriented jobs mirrors structural changes in the labor market, except for clerical jobs. Future return-to-work strategies should not primarily target the clerical sector with its diminishing job opportunities, but promote vocational retraining towards jobs requiring higher education and assistive technology to return individuals with limited cognitive resources to physically oriented jobs.
BACKGROUND: People with spinal cord injuries (SCI) are underrepresented in the labour force. OBJECTIVE: To examine the meaning of employment, as it is understood in the context of participation and integration in society, among persons with SCI in six European countries. We ask how SCI relates to employment, for the functions of employment, alternatives to employment, and its obstacles. METHOD: Semi-structured interviews were conducted with 74 persons and qualitatively analysed using a grounded theory approach. RESULTS: Employment was ranked as very important independent of the participants current employment status. We identified three main functions of employment: 1) employment contributes to the creation of personal and collective identity and social recognition; 2) employment enables structuring of time and distracts from impairment and pain; 3) employment is as an important social arena that facilitates interaction with other people. Voluntary work and domestic work did not fully replace the social functions of employment, nor correspond to the design of the disability compensation systems. CONCLUSION: This study illustrates the high value of employment and a need to pay more attention to a broader range of productive work. It also reveals the interdependencies between employment status and income mediated by the disability compensation schemes.
Employment after Spinal Cord Injury in Norway: A Cross-Sectional Survey
Scandinavian Journal of Disability Research, 2018
Two research questions are addressed: 1) What predicts employment among persons with spinal cord injury (SCI) in Norway? 2) How do the employed compare with the non-employed in their job motivation, labour discrimination, quality of life, everyday coping, health and pain suffering? We use a cross-sectional survey from 2012. With a 51% response rate, 320 Norwegians aged 21-66 years with SCI participated. After injury, 69.5% were employed, and 44.5% remained employed at the time of the interview. There was no gender difference in employment. Among men and women, age at onset of SCI, ability to continue working in the same organisation and education was associated with employment. For men paraplegia and vocational rehabilitation were also significant. Occupational class was non-significant among both men and women. Job motivation and work ability could have affected past employment, and both the employed and non-employed supported the statement that employers discriminate against wheelchair users.
Promoting factors and barriers to participation in working life for people with spinal cord injury
Journal of Occupational Medicine and Toxicology
Background It is still difficult for people with physical impairments to be and remain equally integrated into the labour market. For this reason, the question of occupational activity has explicitly been examined by the German Spinal Cord Injury Survey (GerSCI) in order to identify barriers and facilitators for labour market participation. Methods Cross-sectional explorative observational study. The GerSCI survey is the German part of the International Spinal Cord Injury Survey (InSCI). Using survey data from persons recruited at eight specialised SCI-centres in Germany. Participants: 1.479 persons with Spinal Cord Injury (SCI) aged 18 years and older. Results In a self-disclosure questionnaire, persons with SCI show themselves as a professionally well-educated and highly motivated group with most of them aiming at gainful employment and considering themselves fit for work. Many changeable and non-changeable factors have been found, which showed a high correlation with the return t...
Spinal Cord, 2008
Our aim was to ascertain what effect access to personal care package (PCP) has on the labour market activities of people who have a spinal cord injury (SCI). We developed a new instrument called the spinal injuries survey instrument (SISI). The SISI is a 35-item instrument, which contains items on health, education, employment, along with measures of personal assistance, mobility and psychological attribution style. Materials and methods The SISI was administered, with the Short Form 36 (SF-36) health status instrument, to 250 people with an SCI. The response rate was 72%. A retrospective, matched case-control sampling approach matched individuals who received a PCP, with a cohort who did not. The matching criteria included the site and severity of spinal lesion, age and gender. Results Although data on the reliability of the instrument are currently lacking, our empirical results are consistent with other studies: (1) mean annual health care costs (AUD$8741) are comparable with Walsh's estimates (2) SF-36 data support Kreuter's contention that mental health is resilient to SCI and (3) a post-injury employment rate of 29.7% corroborates Murphy et al. We present additional data describing income, educational attainment and family support. Discussion Our discussion borrows a conceptualization of disability by Sen, that includes both an 'earning handicap' (an impediment to earn income) and a 'conversion handicap' (an impediment to the enjoyment of income). Our application of the SISI provides evidence of both. The labour income of people with quadriplegia is AUD$10 007 per annum, while diminished health status, increased out-ofpocket health expenditure and loss of time suggest a conversion handicap.
Work, 2017
BACKGROUND: Labour market participation (LMP) represents a key goal of rehabilitation for individuals with spinal cord injury (SCI). To achieve this goal, Swiss SCI rehabilitation centres seek, together with their clients, viable follow-up solutions for returning to work after initial rehabilitation. However, the long-term outcomes of such vocational follow-up solutions have not been investigated so far, and there is a paucity of knowledge regarding the various types of employment pathways that persons with SCI living in Switzerland may experience. OBJECTIVE: To examine long-term employment pathways as experienced by individuals with SCI living in Switzerland. METHODS: A qualitative descriptive study design involving narrative interviews with individuals who completed vocational rehabilitation (VR) during their initial rehabilitation. Interviews were transcribed verbatim, and data analysed using an inductive thematic analysis approach. RESULTS: The analysis of the 15 interviews revealed four employment pathways: the pathway of no paid work, the pathway of retraining, the pathway of job adaptation and the pathway of continuing work. CONCLUSIONS: Apart from three pathways leading towards paid employment, our results revealed one pathway that was characterized by permanent unemployment. Individuals facing a pathway of no paid work may benefit from more custom-made vocational follow-up solutions and prolonged job coaching after initial VR.