Article Details

Research Database: Article Details

Citation:  Krause, J.S., Saunders, L.L., & Acuna, J. (2012). Gainful employment and risk of mortality after spinal cord injury: Effects beyond that of demographic, injury, and socioeconomic factors. Spinal Cord, 50 784-788.
Title:  Gainful employment and risk of mortality after spinal cord injury: Effects beyond that of demographic, injury, and socioeconomic factors
Authors:  Krause, J.S., Saunders, L.L., & Acuna, J.
Year:  2012
Journal/Publication:  Spinal Cord
Publisher:  International Spinal Cord Society
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Yes
Research design:  Systematic review / meta-analysis

Structured abstract:

Background:  Increased mortality rates have long been an unfortunate consequence of spinal cord injury (SCI). Many factors can go into mortality rates after SCI and research in the past has focused on socioeconomic status (SES) as one of those factors. Research has shown that generally less household income means a greater rate of mortality. Research into the area should be done to examine the effects of employment status on mortality rates. Since less household income has shown greater mortality rates, improvements in employment outcomes could mean a lesser mortality rate.
Purpose:  The purpose of this study was to identify the effect of employment status (unemployed, 1-29 hours per week, greater than or equal to 30 hours per week) on mortality rates after SCI. This study aimed to isolate employment status from other SES indicators (income, education) as a predictor of mortality rates.
Study sample:  Seven thousand nine hundred fifty five (n=7,955) participants were recruited from a SCI specialty center in the United States. All participants were at least 18 years of age and had SES data collected at least once post discharge.
Intervention:  Employment data from all of the study participants was collected and analyzed. Data on household income and education level was also collected.
Control or comparison condition:  Employment levels and chance of mortality at any employment level were the main focus of this study. Levels were grouped into (a) unemployed, (b) 1-29 hours per week, (c) 30 hours per week or more.
Data collection and analysis:  A logistic regression analysis was done in order to isolate the number of hours worked with the chance of mortality. The strength of the association was studied and reported. The association of education levels and household income with mortality rates was also examined with logistic regression analysis.
Findings:  Mortality rates for those working less than 30 hours per week increased to 1.37 times of those working 30 or more hours per week. The rate was 1.67 times for those who were unemployed.
Conclusions:  The risk of increased mortality is an inevitable consequence for anyone in any demographic that has suffered SCI. Mortality rates jump when socioeconomic characteristics are poor.

Disabilities served:  Spinal cord injury (SCI)