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Q - Employment and Vocation

Employment and Vocation | Body Structure and Function A Jetha, PhD(c); D McCauley, BA; P Athanasopoulos, CA; S Howatt, BA; C Craven, MD; and the E-Scan Investigative Team Employment is a crucial social and economic determinant to health and quality of life of Canadians with spinal cord injury (SCI), and is recommended as an important rehabilitation outcome. Key Definitions Employment is defined as the involvement in paid work for another person, organization or being self-employed in the formal or informal economy.1 Vocation is an occupation in which a person is qualified or trained and finds interesting. Unemployment refers to not being employed but available, capable and searching for work or wanting to work. Underemployment is characterized as inadequate employment situations that may include involuntary part-time work, an inability to utilize training and skills in one’s job, lower job satisfaction, earnings and a reduced likelihood of promotion.1 Importance of Employment Extensive research has highlighted the personal and societal benefits of participating in paid work, following SCI. In particular, employment is a means to economic and residential independence - providing individuals with the opportunity to generate income, access health insurance, interact with others, foster structure and routine for their daily activities, and build self-identity.2,3 Specific to individuals with SCI, involvement in employment is related to improved community independence, fewer secondary health complications, and greater self-confidence.4,5 In addition, involvement in paid work can reduce high, indirect costs of SCI, which (in Canada) have been estimated at $1,154,669, over the lifetime of an individual with SCI. Indirect costs include those associated with premature mortality, high morbidity, productivity losses and both short- and long-term disability.6 SCI and Employment Working-aged Canadians with SCI are more likely to be unemployed and underemployed, when compared to their counterparts without SCI. The most recent large-scale survey of Canadians with SCI found that close to 36% were employed, compared to 70% of their able-bodied peers.7 Additional research finds that employment status ranges from 12% to 74%, based on the characteristics of the SCI sample being studied (e.g., neurological level of injury age at onset, definition of employment or geographical location of study participants).8 Those who return to work following an injury are less likely to go back to their pre-injury job, and more likely to be underemployed. A majority take on less physically-demanding jobs, work part-time hours, have fewer opportunities to receive a promotion, earn lower salaries and report less career satisfaction.8 The employment picture for individuals with SCI is not completely bleak. Despite the low rates of employment and experiences of underemployment, individuals with SCI report high optimism and motivation regarding returning to work, following their injury.8 With appropriate support, they can pursue careers that are satisfying, engaging and meet their career aspirations. EMPLOYMENT AND VOCATION | BODY STRUCTURE AND FNUCTION 177


Q - Employment and Vocation
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