Abstract
Study design
Longitudinal, population-based survey.
Objective
To examine determinants of between-person differences in labor market participation of individuals with spinal cord injury (SCI) living in Switzerland and their potential importance for policy.
Setting
Community.
Methods
Longitudinal information on labor market participation (i.e., paid work or not) was obtained from 1198 and 1035 individuals of working-age participating in the 2012 and 2017 SwiSCI community survey, respectively. Determinants of between-person variation in labor market participation were examined using mixed effects logistic regression, controlling for within-person variation. Employment rates were predicted using counterfactual data for modifiable determinants.
Results
The employment rate was 56% for the 2012 and 61% for the 2017 survey. Labor market participation was affected mostly by static (sex, nationality, SCI severity), temporal (age), dynamic (education level, functional independence, chronic pain), and policy-related (general pension, disability pension level) determinants. Counterfactual (what-if) predictions indicated the highest improvement of employment rates for strategies that increase functional independence (up to 6% increase), foster education (5%), reduce chronic pain (2%), or promote a shift to partial disability pensions (15%).
Conclusions
Between-person variation in labor market participation of persons with SCI is influenced by various temporal, static, dynamic, and policy-related determinants. Our results suggest that policy strategies aimed at enhancing the employment rate of the Swiss SCI population may particularly invest in programs promoting functional independence, education, and partial pension levels that are more adequate for ensuring sustainable employment.
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Data availability
Owing to our commitment to SwiSCI study participants and their privacy, data sets generated during the current study are not made publicly available but can be provided by the SwiSCI Study Center based on reasonable request (contact@swisci.ch).
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Acknowledgements
We thank the SwiSCI Steering Committee with its members Xavier Jordan, Fabienne Reynard (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Laurent Prince (Swiss Paraplegic Association, Nottwil); Heidi Hanselmann (Swiss Paraplegic Foundation, Nottwil); Daniel Joggi (Representative of persons with SCI); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Armin Gemperli (SwiSCI Coordination Group at Swiss Paraplegic Research, Nottwil).
Funding
SwiSCI is hosted and funded by Swiss Paraplegic Research.
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Contributions
US, MWGB, and CF were responsible for designing the conceptual framework of the study. MWGB conducted the statistical analysis. US and MWGB prepared the paper. CF, MF, KK, and SS substantially contributed to the data interpretation or the article preparation. SS provided valuable input from vocational rehabilitation practice.
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The authors declare that they have no conflict of interest.
Ethical approval
Ethical approval for the SwiSCI Survey 2012 was granted by the principal ethics committee on research involving humans of the Canton of Lucerne (KEK Luzern, internal application 11042, approved 28.06.2011) and subsequently endorsed by the additional involved cantonal ethics committees of the Cantons Basel-Stadt (EK Basel, internal application 306/11, approved 06.09.2011) and Valais (CCVEM Sion, internal application CCVEM042/11, approved 06.12.2011). Ethical approval for the SwiSCI Survey 2017 was granted by the leading ethical institution Ethikkommision Nordwest-und Zentralschweiz (EKNZ, Project-ID: 11042 PB_2016-02608, approved Dec 2016). We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.
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Schwegler, U., Fekete, C., Finger, M. et al. Labor market participation of individuals with spinal cord injury living in Switzerland: determinants of between-person differences and counterfactual evaluation of their instrumental value for policy. Spinal Cord 59, 429–440 (2021). https://doi.org/10.1038/s41393-020-00598-x
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DOI: https://doi.org/10.1038/s41393-020-00598-x
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