Impact of family, income assistance and return to work programs on ADLs and employment for individuals with Spinal Cord Injury (SCI): A household decision model

The employment and Activities of Daily Living (ADLs) status of individuals with spinal cord injury (SCI) are critically important for themselves, their families, and their communities. SCI can be devastating, with low employment and family support levels for disabled individuals leading to high poverty rates and major requirements for income assistance from government programs such as SSI, SSDI, Medicare and Medicaid. Return to work programs have only had limited effectiveness in increasing employment and improving the status of the disabled, including those with SCI. However, previous studies of employment and income of individuals with SCI have used cross-sectional data, and have not considered how changes in relevant variables can affect both employment and household income over time. The current research is based on a model of household production and decision making. It examines how changes in household demographics (acquiring or losing a spouse, and arrival or departure of children), the acquisition of education and training, and changes in the need for assistance with ADLs are related to employment prospects and household income of SCI individuals over time. To test the model, the researchers use well-established and validated data from longitudinal surveys of 1,530 SCI individuals in the Southeastern and Midwestern U.S. The results will provide us with a much better understanding of how SCI individuals, and their households, make decisions regarding employment and household income post-injury, and will help policymakers develop more effective public programs to assist SCI-disabled individuals and their families.