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.