A Survival Model of Work Life Expectancy After Spinal Cord Injury: Relationships With Race/Ethnicity, Education, Injury, and Aging Factors

Abstract

Our purpose was to use a survival model to identify the relationships of race/ethnicity, education, aging, sex, and spinal cord injury (SCI) severity factors with work life expectancy, defined by number of years worked after SCI. Data were collected on current employment status and total number of years employed after SCI. Adults who were employed at least 1 year after SCI onset ( n = 1,447) participated. A Cox model was generated to identify the characteristics associated with work life expectancy. Those currently working were censored in the model. Compared with non-Hispanic Whites, Hispanic, non-Hispanic Black, and Native American participants had elevated hazard of employment loss. Those with a 4-year degree or higher had lower hazard of exiting the labor force than those with a high school certificate or less. Being older at injury was associated with greater hazard, whereas greater number of years after the injury was associated with a lower hazard. Sex, SCI severity, and geographic location were not significant. The findings strongly suggest a “hump” of early departure from the labor force for non-Whites and those with less education. Intervention strategies are needed to help people transition to quality employment, which means transitioning to getting over the hump to longer-term employment and career goals.