Community Partnership Needs for Young Adult Stroke Survivors Seeking a Return to Employment: Systematic Review Findings

background: In the U.S., large disparities in stroke incidence and outcomes exist by race and socioeconomic status. Particularly for adults below 55 years of age, returning to employment post-stroke is associated with better mental health. Individuals working in lower occupational grades, however, likely require extensive health and social community-based services to return to employment. To better understand the needs of this vulnerable group, there is a need to synthesize the literature on return-to-employment, community supports, and mental health disparities in post-stroke populations.

methods: For this literature synthesis, studies were identified with electronic searches of five major databases using the terms ”employment” and/or “return to work”, and “stroke.” After applying inclusion and exclusion criteria, 60 studies were included in the review.

results: Preliminary findings point to a significant divide in the type and amount of research conducted by country. Overwhelmingly, Scandinavian countries have focused on return-to-employment as a social determinant of mental health for this population, and how to provide the community-based resources needed to facilitate a return to work. In comparison, the volume of research in the United States has been sparse, and focused on the physiologic basis of employment-related functional deficits.

conclusions: The findings from this review suggest there are critical differences in international interest in, and, understanding of return-to-employment and mental health post-stroke as a public health issue. The findings support the enhancement and expansion of community partnerships to support younger stroke survivors as they seek a return to employment.