Community-level influences on employment for individuals with spinal cord injuries: Implications for health and functioning

Employment for persons with disabilities is a key long-term outcome for medical rehabilitation. In addition to being necessary for individual economic well-being, gainful employment is positively linked to physical and mental health. Rehabilitation outcomes research has largely focused on the influence of individual characteristics (e.g., sociodemographic and diagnostic indicators) in predicting employment and identifying barriers to workforce participation. Evidence of the influence of community factors on health and functioning from the general population suggests that the role of the environment in predicting functional outcomes for persons with disabilities deserves empirical attention. This study examines the effect of county-level characteristics on employment for individuals with spinal cord injury (SCI), and is based on secondary analysis of data from the Northern New Jersey Spinal Cord Injury Systems—part of a national longitudinal database tracking outcomes following SCI. The sample used for the analysis includes participants who completed at least one follow-up interview between 1996 and 2008 (N=521). Multivariate logistic regression is used to predict the association between county-level explanatory variables (e.g., median household income, proportion of unemployed residents, and proportion of high school graduates). The preliminary results suggest that community factors influence the likelihood of employment following SCI. The implications of extending this analysis to the national SCI database and using multilevel analysis to control the effects of clustering will be discussed. This study underscores the importance of assessing the influence of contextual factors on the functioning of persons with disabilities who are living in the community.