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People With Spinal Cord Injury/Disease in the Labor Market: A Comparative Outlook

  • Reuben Escorpizo*
  • , Rutger Osterthun
  • , Sinikka Hiekkala
  • , Onyoo Kim
  • , Mercè Avellanet
  • , Lorena Berna
  • , Aatik Arsh
  • , InSCI
  • *Corresponding author for this work
  • University of Vermont
  • The Finnish Association of People with Physical Disability
  • University of Jyväskylä
  • Korea National Rehabilitation Center
  • Hospital Nostra Sra Meritxell
  • Chile Siloé Rehabilitation Center
  • Khyber Medical University
  • The University of Sydney
  • Kolling Institute of Medical Research
  • Bangladesh Medical University
  • Praxis Spinal Cord Institute
  • University del Valle
  • Pontifical Catholic University
  • CHU de Nantes
  • University Hospital Heidelberg
  • G. Gennimatas General Hospital
  • Sri Balaji Action Medical Institute
  • University of Indonesia
  • Guilan Road Trauma Research Center (GUMS)
  • Humanitas University
  • University of Jordan
  • University of Malaya
  • Abdelmalek Essaâdi University
  • Yangon General Hospital
  • Canterbury District Health Board
  • Sunnaas Rehabilitation Hospital
  • Clinical Rehabilitation Hospital Felix Spa
  • Stellenbosch University
  • University of Gothenburg
  • University of Lucerne
  • Chiang Mai University
  • Istanbul Medeniyet University
  • Johns Hopkins University
  • Norwegian University of Science and Technology

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Abstract

Objectives: To describe the employment of people with spinal cord injury/disease (SCI/D) and identify employment-associated factors among participating countries in the International Spinal Cord Injury 2024. Design: Cross-sectional, multinational, observational cohort study. Setting: Community setting with participants from 31 countries representing all 6 World Health Organization regions. Participants: A total of 11,170 working age people (N=11,170) with SCI/D were analyzed. Interventions: Not applicable. Main Outcome Measures: International Spinal Cord Injury (InSCI) Community Survey. Results: The majority were men (72.4%), most persons had paraplegia (65.6%), incomplete (57.2%), and traumatic as cause of injury (77.5%). The median age was 45.5 years, the median time since injury was 11 years, and the median total years of education was 12 years. A third of the respondents were engaged in paid work (33.1%). Participants from lower middle-income countries had 59% lower odds (OR=0.413; 95% CI, 0.363-0.469; P<.001) of employment compared with high-income countries. Modifiable factors that positively influence employment included education and receiving vocational rehabilitation. Conclusions: A major finding of this study is the difference in employment rates and employment factors for people with an SCI/D in high-income countries versus low income countries. Although employment can powerfully facilitate wellbeing in this population, it is heavily influenced by broader socioeconomic factors that vary across countries. Efforts can be targeted toward addressing education and vocational rehabilitation to improve employment of people post-SCI/D.

Original languageEnglish
Pages (from-to)587-594
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Volume107
Issue number4
DOIs
Publication statusPublished - Apr 2026

Bibliographical note

Publisher Copyright:
© 2025 American Congress of Rehabilitation Medicine

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