People With Spinal Cord Injury/Disease in the Labor Market: A Comparative Outlook.

OBJECTIVES

To describe the employment of people with spinal cord injury/disease (SCI/D) and identify employment-associated factors among participating countries in the International Spinal Cord Injury 2024.

DESIGN

Cross-sectional, multinational, observational cohort study.

SETTING

Community setting with participants from 31 countries representing all 6 World Health Organization regions.

PARTICIPANTS

A total of 11,170 working age people (N=11,170) with SCI/D were analyzed.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: International Spinal Cord Injury (InSCI) Community Survey.

RESULTS

The majority were men (72.4%), most persons had paraplegia (65.6%), incomplete (57.2%), and traumatic as cause of injury (77.5%). The median age was 45.5 years, the median time since injury was 11 years, and the median total years of education was 12 years. A third of the respondents were engaged in paid work (33.1%). Participants from lower middle-income countries had 59% lower odds (OR=0.413; 95% CI, 0.363-0.469; P<.001) of employment compared with high-income countries. Modifiable factors that positively influence employment included education and receiving vocational rehabilitation.

CONCLUSIONS

A major finding of this study is the difference in employment rates and employment factors for people with an SCI/D in high-income countries versus low income countries. Although employment can powerfully facilitate wellbeing in this population, it is heavily influenced by broader socioeconomic factors that vary across countries. Efforts can be targeted toward addressing education and vocational rehabilitation to improve employment of people post-SCI/D.