Employment after spinal cord injury: An analysis of cases from the model spinal cord injury systems

Objective: To describe the relationship of multiple biographic, injury-rela ted, and educational factors with employment outcomes after spinal cord inj ury (SCI), Design: Cross-sectional. Setting: Data were collected through 18 model SCI systems, a nationwide net work of hospitals that treat approximately 14% of all SCIs in the United St ates. Participants: A total of 3,756 persons with traumatic SCI who completed the Form II data collection during their annual follow-up at years 1, 2, 5, 10 , 15, 20, or 25 years (the most recent Form II: was accepted). Main Outcome Measures: The Model Systems Forms I and II were used to identi fy biographic, injury-related status, employment at injury, and productivit y status upon follow-up (Form I is used to elicit basic demographic and dis charge information, whereas Form II is used to track multiple outcomes duri ng annual follow-ups). The Craig Handicap Assessment Reporting Technique (C HART) was used to assess hours spent in gainful employment and other produc tive activities. Results: CHART data revealed only a modestly higher employment rate (24.8%) than that of the traditional single Form II item (22%). Being Caucasian;yo unger at injury, having lived more years with SCI, having a less severe inj ury, and having more years of education were all predictive of being employ ed. Violence at injury was associated with lower employment rates (only 12. 9% employed), especially among Caucasians (only 24% employed). Being employ ed at injury was associated with a greater probability of postinjury employ ment, but only in the first few years after injury. Among employed particip ants, women and those who had been injured fewer years averaged fewer hours spent at work. Conclusions: Findings were consistent with those in previous studies. Inter ventions to improve employability should focus on education and the needs o f individuals from minority backgrounds. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine an d Rehabilitation.