Gender, class, employment status and social mobility following spinal cord injury in Denmark, the Netherlands, Norway and Switzerland

Abstract

Study design Cross sectional survey of 1055 persons with spinal cord injury (SCI) in Denmark, the Netherlands, Norway and Switzerland.Objectives (1) To analyse the employment levels of people of working age with SCI, including possible gender differences.(2) To study the relevance of occupational class before SCI and its impact on employment and occupational class after SCI. Setting Members of national SCI consumer associations. Methods Employment status and social mobility after SCI was regressed on occupational class before SCI, using multinomial and binary logistic regression analysis of employment, while controlling for other explanatory variables to employment after SCI and demographic characteristics. Results Employment levels after injury were similar for men and women in each of the four nations, but Dutch women had significantly lower scores on predicted employment than Dutch men. Employment and social mobility trajectories were heavily in favour of middle-class occupations. Gender differences in employment status at the time of study primarily occurred among those in working-class occupations before SCI, with men less likely than women of being non-employed. Working-class men were significantly more likely than working-class women to retain a working-class occupation at the time of study, and although non-significant, to attain a middle-class occupation after SCI. Conclusion There was little variation in employment by gender within and across countries but significant differences between working-class and middle-class occupations before and after injury. The results suggest that targeted employment measures should be particularly invested in the rehabilitation of women in working-class occupations.

Employment Among People With Spinal Cord Injury in 22 Countries Across the World: Results From the International Spinal Cord Injury Community Survey

“…This difference can also be found in the literature. Employment rates reported in the literature are 35% to 48.1% for Norway, 9,16,17 50.8% to 60% for the Netherlands, 9,18,19 and 54.4% to 63.8% for Switzerland. 20,21 The only figures from Southern Europe we could find were 12.4% for Spain 22 and 34.7% for Italy.…”

“…The worldwide employment rate of 38% in this study is similar to the employment rates ranging from 36% to 38% reported in available literature reviews. 3,5,6 Except for 1 study in 4 Western European countries, 9 no previous studies included samples from multiple countries. Therefore, comparisons with the literature are only possible on a country-by-country basis.…”

“…5,7 This variation between countries suggests that system-level, infrastructure, and policy differences may play a role in affecting work outcomes. 8 Further investigation of such differences requires studies that compare multiple countries, but with few exceptions, 9 studies on employment post-SCI are notably absent in the literature. Therefore, the best available evidence to date stems from comparisons of single-country studies.…”

Quality of life in patients with tetraplegia and paraplegia after traumatic spinal cord injury

“…The reduced professional activity of patients with SCI is responsible for changes in social status and may affect the financial situation of the family [1,21,22]. Returning to professional activity after SCI is very challenging for most of patients.…”

“…Spinal cord injury (SCI) leads to incommensurable individual and social effects [1], although it is not a common injury. SCI disrupts the functioning of body systems and causes enormous changes and limitations in many areas of life (psychological, social and socio-professional), resulting in disability.…”